Details

Autor(en) / Beteiligte

• Calmon, Raphael
• Puget, Stephanie
• Varlet, Pascale
• Beccaria, Kevin
• Blauwblomme, Thomas
• Grevent, David
• Sainte-Rose, Christian
• Castel, David
• Dufour, Christelle
• Dhermain, Frédéric
• Bolle, Stéphanie
• Saitovitch, Ana
• Zilbovicius, Monica
• Brunelle, Francis
• Grill, Jacques
• Boddaert, Nathalie

Titel

Multimodal Magnetic Resonance Imaging of Treatment Induced Changes to Diffuse Infiltrating Pontine Gliomas in Children and Correlation to Patient Progression Free Survival

Ist Teil von

• International journal of radiation oncology, biology, physics, 2017-10, Vol.99 (2), p.476-485

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Purpose To use multimodal magnetic resonance imaging to quantify treatment induced changes in the whole volume of diffuse infiltrating pontine gliomas (DIPG) and correlate them with progression free survival (PFS). Material and Methods This prospective study, included 22 children aged 3.3 to 14.7 years (median 5.9). Multimodal magnetic resonance imaging (MRI) was performed in three distinct time points: before treatment, repeated the first week following radiation therapy (RT), and 2 months later. The imaging protocol included morphological, multi b-value diffusion, arterial spin labelling, and dynamic susceptibility contrast enhanced perfusion. Morphological and multimodal data — lesion volume, diffusion coefficients, relative blood flow (rCBF) and relative blood volume (rCBV) — were recorded at these three time points. Wilcoxon test was used to compare each individual parameter variation between time points and its correlation with PFS was assessed by Spearman's test. Results Following RT, the tumors' solid component volume decreased by 40% (p<0.001). Their median diffusion coefficients decreased by 20-40% (p<0.001), while median rCBF increased by 60-80% (p<0.001) and median rCBV increased by 70% (p<0.001). The PFS was positively correlated with rCBV measured immediately after RT (p=0.003) and, in patients whose rCBV was above the cut-off value of 2.46, the median PFS was 4.6 months longer (p=0.001). These indexes tended to return to the base line 2 months after RT. Lesion volume before or after RT was not correlated with survival. Conclusions Multimodal MRI provides useful information about DIPGs response to treatment, rCBV increases following RT and higher values are correlated with better PFS. High rCBV values following RT should not be mistaken for progression and could be an indicator of response to therapy