Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2018

01-06-2018 | Neuro

Multiparametric MRI as a potential surrogate endpoint for decision-making in early treatment response following concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma: a systematic review and meta-analysis

Authors: Chong Hyun Suh, Ho Sung Kim, Seung Chai Jung, Choong Gon Choi, Sang Joon Kim

Published in: European Radiology | Issue 6/2018

Login to get access

Abstract

Objective

To evaluate the value of multiparametric MRI for determination of early treatment response following concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma.

Methods

A computerized search of Ovid-MEDLINE and EMBASE up to 1 October 2017 was performed to find studies on the diagnostic performance of multiparametric MRI for differentiating true progression from pseudoprogression. The beginning search date was not specified. Pooled estimates of sensitivity and specificity were obtained using hierarchical logistic regression modeling. We performed meta-regression and sensitivity analyses to explain the effects of the study heterogeneity.

Results

Nine studies including 456 patients were included. Pooled sensitivity and specificity were 84 % (95 % CI 74–91) and 95 % (95 % CI 83–99), respectively. Area under the hierarchical summary receiver operating characteristic curve was 0.95 (95 % CI 0.92–0.96). Meta-regression showed true progression in the study population, the mean age and the reference standard were significant factors affecting heterogeneity.

Conclusion

Multiparametric MRI may be used as a potential surrogate endpoint for assessment of early treatment response, especially in the differentiation of true progression from pseudoprogression. However, based on the current evidence, monoparametric and multiparametric MRI perform equally in the clinical context. Further evaluation will be needed.

Key Points

• Multiparametric MRI shows high diagnostic performance for early treatment response in glioblastoma.
• Multiparametric MRI could differentiate true progression from pseudoprogression in newly diagnosed glioblastoma.
• The normalized rCBV derived from DSC was the most commonly used parameter.
Appendix
Available only for authorised users
Literature
1.
Abbasi AW, Westerlaan HE, Holtman GA, Aden KM, van Laar PJ, van der Hoorn A (2017) Incidence of tumour progression and pseudoprogression in high-grade gliomas: a systematic review and meta-analysis. Clin Neuroradiol
2.
Brandes AA, Franceschi E, Tosoni A et al (2008) MGMT promoter methylation status can predict the incidence and outcome of pseudoprogression after concomitant radiochemotherapy in newly diagnosed glioblastoma patients. J Clin Oncol 26:2192–2197CrossRefPubMed
3.
Stuplich M, Hadizadeh DR, Kuchelmeister K et al (2012) Late and prolonged pseudoprogression in glioblastoma after treatment with lomustine and temozolomide. J Clin Oncol 30:e180–e183CrossRefPubMed
4.
Wen PY, Macdonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972CrossRefPubMed
5.
van Dijken BR, van Laar PJ, Holtman GA, van der Hoorn A (2017) Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis. Eur Radiol
6.
Cha J, Kim ST, Kim HJ et al (2014) Differentiation of tumor progression from pseudoprogression in patients with posttreatment glioblastoma using multiparametric histogram analysis. AJNR Am J Neuroradiol 35:1309–1317CrossRefPubMed
7.
Choi YJ, Kim HS, Jahng GH, Kim SJ, Suh DC (2013) Pseudoprogression in patients with glioblastoma: added value of arterial spin labeling to dynamic susceptibility contrast perfusion MR imaging. Acta Radiol 54:448–454CrossRefPubMed
8.
Di Costanzo A, Scarabino T, Trojsi F et al (2014) Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach. Radiol Med 119:616–624CrossRefPubMed
9.
Hu X, Wong KK, Young GS, Guo L, Wong ST (2011) Support vector machine multiparametric MRI identification of pseudoprogression from tumor recurrence in patients with resected glioblastoma. J Magn Reson Imaging 33:296–305CrossRefPubMedPubMedCentral
10.
Park JE, Kim HS, Goh MJ, Kim SJ, Kim JH (2015) Pseudoprogression in patients with glioblastoma: assessment by using volume-weighted voxel-based multiparametric clustering of MR imaging data in an independent test set. Radiology 275:792–802CrossRefPubMed
11.
Prager AJ, Martinez N, Beal K, Omuro A, Zhang Z, Young RJ (2015) Diffusion and perfusion MRI to differentiate treatment-related changes including pseudoprogression from recurrent tumors in high-grade gliomas with histopathologic evidence. AJNR Am J Neuroradiol 36:877–885CrossRefPubMedPubMedCentral
12.
Seeger A, Braun C, Skardelly M et al (2013) Comparison of three different MR perfusion techniques and MR spectroscopy for multiparametric assessment in distinguishing recurrent high-grade gliomas from stable disease. Acad Radiol 20:1557–1565CrossRefPubMed
13.
Wang S, Martinez-Lage M, Sakai Y et al (2016) Differentiating tumor progression from pseudoprogression in patients with glioblastomas using diffusion tensor imaging and dynamic susceptibility contrast MRI. AJNR Am J Neuroradiol 37:28–36CrossRefPubMed
14.
Yoo RE, Choi SH, Kim TM et al (2015) Independent poor prognostic factors for true progression after radiation therapy and concomitant temozolomide in patients with glioblastoma: subependymal enhancement and low ADC value. AJNR Am J Neuroradiol 36:1846–1852CrossRefPubMed
15.
Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151:W65–W94CrossRefPubMed
16.
Whiting PF, Rutjes AW, Westwood ME et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536CrossRefPubMed
17.
18.
19.
Suh CH, Park SH (2016) Successful publication of systematic review and meta-analysis of studies evaluating diagnostic test accuracy. Korean J Radiol 17:5–6CrossRefPubMedPubMedCentral
20.
Kim KW, Lee J, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part I. general guidance and tips. Korean J Radiol 16:1175–1187CrossRefPubMedPubMedCentral
21.
Lee J, Kim KW, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. Statistical methods of meta-analysis. Korean J Radiol 16:1188–1196CrossRefPubMedPubMedCentral
22.
Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893CrossRefPubMed
23.
Hygino da Cruz LC Jr, Rodriguez I, Domingues RC, Gasparetto EL, Sorensen AG (2011) Pseudoprogression and pseudoresponse: imaging challenges in the assessment of posttreatment glioma. AJNR Am J Neuroradiol 32:1978–1985CrossRefPubMed
24.
Jensen RL (2009) Brain tumor hypoxia: tumorigenesis, angiogenesis, imaging, pseudoprogression, and as a therapeutic target. J Neurooncol 92:317–335CrossRefPubMed
25.
Hyare H, Thust S, Rees J (2017) Advanced MRI techniques in the monitoring of treatment of gliomas. Curr Treat Options Neurol 19:11CrossRefPubMed
26.
27.
Trikalinos TA, Balion CM, Coleman CI et al (2012) Chapter 8: meta-analysis of test performance when there is a ‘gold standard’. J Gen Intern Med 27(Suppl 1):S56–S66CrossRefPubMed
Metadata
Title
Multiparametric MRI as a potential surrogate endpoint for decision-making in early treatment response following concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma: a systematic review and meta-analysis
Authors
Chong Hyun Suh
Ho Sung Kim
Seung Chai Jung
Choong Gon Choi
Sang Joon Kim
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5262-5

Other articles of this Issue 6/2018

European Radiology 6/2018 Go to the issue

Gastrointestinal

Demystifying liver iron concentration measurements with MRI

Musculoskeletal

How, When, Why in Magnetic Resonance Arthrography: an International Survey by the European Society of Musculoskeletal Radiology (ESSR)

Magnetic Resonance

Magnetic resonance cholangiopancreatography with GRASE sequence at 3.0T: does it improve image quality and acquisition time as compared with 3D TSE?

Oncology

Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma

Radiological Education

To share or not to share? Expected pros and cons of data sharing in radiological research

Breast

Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis