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Journal of Neuro-Oncology
Published in: Journal of Neuro-Oncology 1/2016

01-10-2016 | Clinical Study

Do perfusion and diffusion MRI predict glioblastoma relapse sites following chemoradiation?

Authors: Jonathan Khalifa, Fatima Tensaouti, Jean-Albert Lotterie, Isabelle Catalaa, Leonor Chaltiel, Alexandra Benouaich-Amiel, Carlos Gomez-Roca, Georges Noël, Gilles Truc, Patrice Péran, Isabelle Berry, Marie-Pierre Sunyach, Marie Charissoux, Corinne Johnson, Elizabeth Cohen-Jonathan Moyal, Anne Laprie

Published in: Journal of Neuro-Oncology | Issue 1/2016

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Abstract

To assess the value of T2* dynamic-susceptibility contrast MRI (DSC-MRI) and diffusion-weighted imaging (DWI) to predict the glioblastoma relapse sites after chemoradiation. From a cohort of 44 patients, primarily treated with radiotherapy (60 Gy) and concomitant temozolomide for glioblastoma, who were included in the reference arm of a prospective clinical trial (NCT01507506), 15 patients relapsed and their imaging data were analyzed. All patients underwent anatomical MRI, DSC-MRI and DWI before radiotherapy and every 2 months thereafter until relapse. Voxels within the sites of relapse were correlated with their perfusion and/or diffusion abnormality (PDA) pretreatment status after rigid co-registration. The relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) were used as biomarkers. Several PDA areas were thresholded: hyperperfused voxels using a 1.75 fixed rCBV threshold (HPt); hypoperfused (hPg) and hyperperfused (HPg) voxels using a histogram-based Gaussian method; diffusion-restricted voxels (DRg); and HPg voxels with diffusion restriction (HPg&DRg). Two sets of voxels (2,459,483 and 2,073,880) were analyzed according to these thresholding methods. Positive predictive values (PPV) of PDA voxels were low (between 9.5 and 31.9 %). The best PPV was obtained with HPg&DRg voxels within the FLAIR hyperintensity, as 18.3 % of voxels without initial PDA were within relapse sites, versus 31.9 % with initial PDA (p < 0.0001). This prospective study suggests that DSC and/or DWI-MRI do not predict the glioblastoma relapse sites. However, further investigations with new methodological approaches are needed to better understand the role of these modalities in the prediction of glioblastoma relapse sites.
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Metadata
Title
Do perfusion and diffusion MRI predict glioblastoma relapse sites following chemoradiation?
Authors
Jonathan Khalifa
Fatima Tensaouti
Jean-Albert Lotterie
Isabelle Catalaa
Leonor Chaltiel
Alexandra Benouaich-Amiel
Carlos Gomez-Roca
Georges Noël
Gilles Truc
Patrice Péran
Isabelle Berry
Marie-Pierre Sunyach
Marie Charissoux
Corinne Johnson
Elizabeth Cohen-Jonathan Moyal
Anne Laprie
Publication date
01-10-2016
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 1/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-016-2232-8

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