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Neuroradiology
Published in: Neuroradiology 10/2017

01-10-2017 | Functional Neuroradiology

Response Assessment in Neuro-Oncology criteria, contrast enhancement and perfusion MRI for assessing progression in glioblastoma

Authors: Fatima Tensaouti, Jonathan Khalifa, Amélie Lusque, Benjamin Plas, Jean Albert Lotterie, Isabelle Berry, Anne Laprie, Elizabeth Cohen-Jonathan Moyal, Vincent Lubrano

Published in: Neuroradiology | Issue 10/2017

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Abstract

Purpose

The purpose of the study was to evaluate Response Assessment in Neuro-Oncology (RANO) criteria in glioblastoma multiforme (GBM), with respect to the Macdonald criteria and changes in contrast-enhancement (CE) volume. Related variations in relative cerebral blood volume (rCBV) were investigated.

Methods

Forty-three patients diagnosed between 2006 and 2010 were included. All underwent surgical resection, followed by temozolomide-based chemoradiation. MR images were retrospectively reviewed. Times to progression (TTPs) according to RANO criteria, Macdonald criteria and increased CE volume (CE-3D) were compared, and the percentage change in the 75th percentile of rCBV (rCBV75) was evaluated.

Results

After a median follow-up of 22.7 months, a total of 39 patients had progressed according to RANO criteria, 32 according to CE-3D, and 42 according to Macdonald. Median TTPs were 6.4, 9.3, and 6.6 months, respectively. Overall agreement was 79.07% between RANO and CE-3D and 93.02% between RANO and Macdonald. The mean percentage change in rCBV75 at RANO progression onset was over 73% in 87.5% of patients.

Conclusions

In conclusion, our findings suggest that CE-3D criterion is not yet suitable to assess progression in routine clinical practice. Indeed, the accurate threshold is still not well defined. To date, in our opinion, early detection of disease progression by RANO combined with advanced MRI imaging techniques like MRI perfusion and diffusion remains the best way to assess disease progression. Further investigations that would examine the impact of treatment modifications after progression determined by different criteria on overall survival would be of great value.
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Metadata
Title
Response Assessment in Neuro-Oncology criteria, contrast enhancement and perfusion MRI for assessing progression in glioblastoma
Authors
Fatima Tensaouti
Jonathan Khalifa
Amélie Lusque
Benjamin Plas
Jean Albert Lotterie
Isabelle Berry
Anne Laprie
Elizabeth Cohen-Jonathan Moyal
Vincent Lubrano
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 10/2017
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-017-1899-7

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