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01-01-2015 | Clinical Study

Outcome of radiosurgery for recurrent malignant gliomas: assessment of treatment response using relative cerebral blood volume

Authors: Hong Rye Kim, Se-Hwan Kim, Jung-Il Lee, Ho Jun Seol, Do-Hyun Nam, Sung Tae Kim, Kwan Park, Jong Hyun Kim, Doo-Sik Kong

Published in: Journal of Neuro-Oncology | Issue 2/2015

Abstract

Gamma knife radiosurgery (GKS) is efficacious for treating recurrent malignant gliomas as a salvage treatment. However, contrast enhancement alone on MR imaging remains difficult to determine the treatment response following GKS. The purpose of this study was to evaluate the radiosurgical effect for recurrent malignant gliomas and to clarify if relative cerebral blood volume (rCBV) derived from dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MR imaging could represent the treatment response. Between March 2006 and December 2008, 38 patients underwent GKS for recurrent malignant gliomas. Before and after GKS, DSC perfusion MR imaging datasets were retrospectively reprocessed and regions of interest were drawn around the contrast-enhancing region targeted with GKS. DSC-perfusion MR scans were assessed at a regular interval of two months. Following GKS for the recurrent lesions, MR images showed response (stable disease or partial response) in 26 of 38 patients (68.4 %) at post-GKS 2 months and 18 of 38 patients (47.3 %) at post-GKS 4 months. Initial mean rCBV value was 2.552 (0.586–6.178) at the pre-GKS MRI. In the response group, mean rCBV value was significantly decreased (P < 0.05) at the follow up of 2 and 4 months. However, in the treatment-failure group, mean rCBV value had no significant change. We suggest that GKS is an alternative treatment choice for the recurrent glioma. DSC-perfusion MR images are helpful to predict the treatment response after GKS.

Behin A, Hoang-Xuan K, Carpentier AF, Delattre JY (2003) Primary brain tumours in adults. Lancet 361:323–331PubMedCrossRef

Gupta T, Sarin R (2002) Poor-prognosis high-grade gliomas: evolving an evidence-based standard of care. Lancet Oncol 3:557–564PubMedCrossRef

Scott CB, Scarantino C, Urtasun R, Movsas B, Jones CU, Simpson JR, Fischbach AJ, Curran WJ Jr (1998) Validation and predictive power of radiation therapy oncology group (RTOG) recursive partitioning analysis classes for malignant glioma patients: a report using RTOG 90-06. Int J Radiat Oncol Biol Phys 40:51–55PubMedCrossRef

Stewart LA (2002) Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 359:1011–1018PubMedCrossRef

Barker FG 2nd, Chang SM, Gutin PH, Malec MK, McDermott MW, Prados MD, Wilson CB (1998) Survival and functional status after resection of recurrent glioblastoma multiforme. Neurosurgery 42:709–720 discussion 720–703PubMedCrossRef

Combs SE, Gutwein S, Thilmann C, Huber P, Debus J, Schulz-Ertner D (2005) Stereotactically guided fractionated re-irradiation in recurrent glioblastoma multiforme. J Neurooncol 74:167–171PubMedCrossRef

Combs SE, Widmer V, Thilmann C, Hof H, Debus J, Schulz-Ertner D (2005) Stereotactic radiosurgery (SRS): treatment option for recurrent glioblastoma multiforme (GBM). Cancer 104:2168–2173PubMedCrossRef

Sneed PK, Gutin PH, Larson DA, Malec MK, Phillips TL, Prados MD, Scharfen CO, Weaver KA, Wara WM (1994) Patterns of recurrence of glioblastoma multiforme after external irradiation followed by implant boost. Int J Radiat Oncol Biol Phys 29:719–727PubMedCrossRef

Ammirati M, Galicich JH, Arbit E, Liao Y (1987) Reoperation in the treatment of recurrent intracranial malignant gliomas. Neurosurgery 21:607–614PubMedCrossRef

10.

Brandes AA, Pasetto LM, Monfardini S (2000) New drugs in recurrent high grade gliomas. Anticancer Res 20:1913–1920PubMed

11.

Brem H, Piantadosi S, Burger PC, Walker M, Selker R, Vick NA, Black K, Sisti M, Brem S, Mohr G et al (1995) Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Polym-brain Tumor Treat Group. Lancet 345:1008–1012

12.

Chua SL, Rosenthal MA, Wong SS, Ashley DM, Woods AM, Dowling A, Cher LM (2004) Phase 2 study of temozolomide and caelyx in patients with recurrent glioblastoma multiforme. Neuro Oncol 6:38–43PubMedCentralPubMedCrossRef

13.

Hochberg FH, Pruitt A (1980) Assumptions in the radiotherapy of glioblastoma. Neurology 30:907–911PubMedCrossRef

14.

Masciopinto JE, Levin AB, Mehta MP, Rhode BS (1995) Stereotactic radiosurgery for glioblastoma: a final report of 31 patients. J Neurosurg 82:530–535PubMedCrossRef

15.

Rajan B, Ross G, Lim CC, Ashley S, Goode D, Traish D, Brada M (1994) Survival in patients with recurrent glioma as a measure of treatment efficacy: prognostic factors following nitrosourea chemotherapy. Eur J Cancer 30A:1809–1815PubMedCrossRef

16.

Wallner KE, Galicich JH, Krol G, Arbit E, Malkin MG (1989) Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys 16:1405–1409PubMedCrossRef

17.

Larson DA, Gutin PH, McDermott M, Lamborn K, Sneed PK, Wara WM, Flickinger JC, Kondziolka D, Lunsford LD, Hudgins WR, Friehs GM, Haselsberger K, Leber K, Pendl G, Chung SS, Coffey RJ, Dinapoli R, Shaw EG, Vermeulen S, Young RF, Hirato M, Inoue HK, Ohye C, Shibazaki T (1996) Gamma knife for glioma: selection factors and survival. Int J Radiat Oncol Biol Phys 36:1045–1053PubMedCrossRef

18.

Hsieh PC, Chandler JP, Bhangoo S, Panagiotopoulos K, Kalapurakal JA, Marymont MH, Cozzens JW, Levy RM, Salehi S (2005) Adjuvant gamma knife stereotactic radiosurgery at the time of tumor progression potentially improves survival for patients with glioblastoma multiforme. Neurosurgery 57:684–692 discussion 684–692PubMedCrossRef

19.

Mahajan A, McCutcheon IE, Suki D, Chang EL, Hassenbusch SJ, Weinberg JS, Shiu A, Maor MH, Woo SY (2005) Case-control study of stereotactic radiosurgery for recurrent glioblastoma multiforme. J Neurosurg 103:210–217PubMedCrossRef

20.

Shrieve DC, Alexander E 3rd, Wen PY, Fine HA, Kooy HM, Black PM, Loeffler JS (1995) Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme. Neurosurgery 36:275–282 discussion 282–274PubMedCrossRef

21.

Leon SP, Folkerth RD, Black PM (1996) Microvessel density is a prognostic indicator for patients with astroglial brain tumors. Cancer 77:362–372PubMedCrossRef

22.

Aronen HJ, Gazit IE, Louis DN, Buchbinder BR, Pardo FS, Weisskoff RM, Harsh GR, Cosgrove GR, Halpern EF, Hochberg FH et al (1994) Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 191:41–51PubMedCrossRef

23.

Cha S, Johnson G, Wadghiri YZ, Jin O, Babb J, Zagzag D, Turnbull DH (2003) Dynamic, contrast-enhanced perfusion MRI in mouse gliomas: correlation with histopathology. Magn Reson Med 49:848–855PubMedCrossRef

24.

Hirai T, Murakami R, Nakamura H, Kitajima M, Fukuoka H, Sasao A, Akter M, Hayashida Y, Toya R, Oya N, Awai K, Iyama K, Kuratsu JI, Yamashita Y (2008) Prognostic value of perfusion MR imaging of high-grade astrocytomas: long-term follow-up study. AJNR Am J Neuroradiol 29:1505–1510PubMedCrossRef

25.

Knopp EA, Cha S, Johnson G, Mazumdar A, Golfinos JG, Zagzag D, Miller DC, Kelly PJ, Kricheff II (1999) Glial neoplasms: dynamic contrast-enhanced T2*-weighted MR imaging. Radiology 211:791–798PubMedCrossRef

26.

Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T, Shigematsu Y, Liang L, Ge Y, Ushio Y, Takahashi M (1998) Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol 171:1479–1486PubMedCrossRef

27.

Wong JC, Provenzale JM, Petrella JR (2000) Perfusion MR imaging of brain neoplasms. AJR Am J Roentgenol 174:1147–1157PubMedCrossRef

28.

Donahue KM, Krouwer HG, Rand SD, Pathak AP, Marszalkowski CS, Censky SC, Prost RW (2000) Utility of simultaneously acquired gradient-echo and spin-echo cerebral blood volume and morphology maps in brain tumor patients. Magn Reson Med 43:845–853PubMedCrossRef

29.

Rosen BR, Belliveau JW, Buchbinder BR, McKinstry RC, Porkka LM, Kennedy DN, Neuder MS, Fisel CR, Aronen HJ, Kwong KK et al (1991) Contrast agents and cerebral hemodynamics. Magn Reson Med 19:285–292PubMedCrossRef

30.

Rosen BR, Belliveau JW, Vevea JM, Brady TJ (1990) Perfusion imaging with NMR contrast agents. Magn Reson Med 14:249–265PubMedCrossRef

31.

Barbier EL, Lamalle L, Decorps M (2001) Methodology of brain perfusion imaging. J Magn Reson Imaging 13:496–520PubMedCrossRef

32.

Souhami L, Seiferheld W, Brachman D, Podgorsak EB, Werner-Wasik M, Lustig R, Schultz CJ, Sause W, Okunieff P, Buckner J, Zamorano L, Mehta MP, Curran WJ Jr (2004) Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme: report of radiation therapy oncology group 93-05 protocol. Int J Radiat Oncol Biol Phys 60:853–860PubMedCrossRef

33.

Kong DS, Lee JI, Park K, Kim JH, Lim DH, Nam DH (2008) Efficacy of stereotactic radiosurgery as a salvage treatment for recurrent malignant gliomas. Cancer 112:2046–2051PubMedCrossRef

34.

Tsao MN, Mehta MP, Whelan TJ, Morris DE, Hayman JA, Flickinger JC, Mills M, Rogers CL, Souhami L (2005) The American society for therapeutic radiology and oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant glioma. Int J Radiat Oncol Biol Phys 63:47–55PubMedCrossRef

35.

Law M, Oh S, Babb JS, Wang E, Inglese M, Zagzag D, Knopp EA, Johnson G (2006) Low-grade gliomas: dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging–prediction of patient clinical response. Radiology 238:658–667PubMedCrossRef

36.

Lev MH, Ozsunar Y, Henson JW, Rasheed AA, Barest GD, Harsh GRt, Fitzek MM, Chiocca EA, Rabinov JD, Csavoy AN, Rosen BR, Hochberg FH, Schaefer PW, Gonzalez RG (2004) Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol 25:214–221PubMed

37.

Mills SJ, Patankar TA, Haroon HA, Baleriaux D, Swindell R, Jackson A (2006) Do cerebral blood volume and contrast transfer coefficient predict prognosis in human glioma? AJNR Am J Neuroradiol 27:853–858PubMed

38.

Oh J, Henry RG, Pirzkall A, Lu Y, Li X, Catalaa I, Chang S, Dillon WP, Nelson SJ (2004) Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume. J Magn Reson Imaging 19:546–554PubMedCrossRef

39.

Tzika AA, Astrakas LG, Zarifi MK, Zurakowski D, Poussaint TY, Goumnerova L, Tarbell NJ, Black PM (2004) Spectroscopic and perfusion magnetic resonance imaging predictors of progression in pediatric brain tumors. Cancer 100:1246–1256PubMedCrossRef

40.

Burger PC, Dubois PJ, Schold SC Jr, Smith KR Jr, Odom GL, Crafts DC, Giangaspero F (1983) Computerized tomographic and pathologic studies of the untreated, quiescent, and recurrent glioblastoma multiforme. J Neurosurg 58:159–169PubMedCrossRef

41.

Burger PC, Heinz ER, Shibata T, Kleihues P (1988) Topographic anatomy and CT correlations in the untreated glioblastoma multiforme. J Neurosurg 68:698–704PubMedCrossRef

42.

Halperin EC, Bentel G, Heinz ER, Burger PC (1989) Radiation therapy treatment planning in supratentorial glioblastoma multiforme: an analysis based on post mortem topographic anatomy with CT correlations. Int J Radiat Oncol Biol Phys 17:1347–1350PubMedCrossRef

43.

Kelly PJ, Daumas-Duport C, Scheithauer BW, Kall BA, Kispert DB (1987) Stereotactic histologic correlations of computed tomography- and magnetic resonance imaging-defined abnormalities in patients with glial neoplasms. Mayo Clin Proc 62:450–459PubMedCrossRef

44.

Lunsford LD, Martinez AJ, Latchaw RE (1986) Magnetic resonance imaging does not define tumor boundaries. Acta Radiol Suppl 369:154–156PubMed

Title: Outcome of radiosurgery for recurrent malignant gliomas: assessment of treatment response using relative cerebral blood volume
Authors: Hong Rye Kim
Se-Hwan Kim
Jung-Il Lee
Ho Jun Seol
Do-Hyun Nam
Sung Tae Kim
Kwan Park
Jong Hyun Kim
Doo-Sik Kong
Publication date: 01-01-2015
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2015
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-014-1634-8

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Outcome of radiosurgery for recurrent malignant gliomas: assessment of treatment response using relative cerebral blood volume

Abstract

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Abstract

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