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Low rCBV values in glioblastoma tumor progression under chemoradiotherapy

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

After standard treatment for glioblastoma, perfusion MRI remains challenging for differentiating tumor progression from post-treatment changes. Our objectives were (1) to correlate rCBV values at diagnosis and at first tumor progression and (2) to analyze the relationship of rCBV values at tumor recurrence with enhancing volume, localization of tumor progression, and time elapsed since the end of radiotherapy in tumor recurrence.

Methods

Inclusion criteria were (1) age > 18 years, (2) histologically confirmed glioblastoma treated with STUPP regimen, and (3) tumor progression according to RANO criteria > 12 weeks after radiotherapy. Co-registration of segmented enhancing tumor VOIs with dynamic susceptibility contrast perfusion MRI was performed using Olea Sphere software. For tumor recurrence, we correlated rCBV values with enhancing tumor volume, with recurrence localization, and with time elapsed from the end of radiotherapy to progression. Analyses were performed with SPSS software.

Results

Sixty-four patients with glioblastoma were included in the study. Changes in rCBV values between diagnosis and first tumor progression were significant (p < 0.001), with a mean and median decreases of 32% and 46%, respectively. Mean rCBV values were also different (p < 0.01) when tumors progressed distally (radiation field rCBV values of 1.679 versus 3.409 distally). However, changes and, therefore, low rCBV values after radiotherapy in tumor recurrence were independent of time.

Conclusion

Chemoradiation alters tumor perfusion and rCBV values may be decreased in the setting of tumor progression. Changes in rCBV values with respect to diagnosis, with low rCBV in tumor progression, are independent of time but related to the site of recurrence.

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Abbreviations

DSC:

Dynamic susceptibility contrast

IAUC:

Initial area under the curve

IDH:

Isocitrate dehydrogenase

RANO:

Response assessment in neuro-oncology

S:

Sensitivity

SD:

Standard deviation

WHO:

World Health Organization

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Funding

This work was partially supported by grants PI21/01168 and PI21/01406 from the Spanish Instituto de Salud Carlos III.

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Authors and Affiliations

  1. Department of Radiology, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041, Madrid, Spain

    A. Hilario, E. Salvador, A. Cardenas, J. Romero, C. Lechuga, Z. Chen, A. Martinez de Aragon & A. Ramos

  2. Department of Neurosurgery, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041, Madrid, Spain

    A. Perez-Nuñez & A. Lagares

  3. Department of Neuropathology, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041, Madrid, Spain

    A. Hernandez-Lain & O. Toldos

  4. Department of Medical Oncology, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041, Madrid, Spain

    J. Sepulveda

  5. Department of Radiation Oncology, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041, Madrid, Spain

    V. Rodriguez-Gonzalez

Authors
  1. A. Hilario
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  2. E. Salvador
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  3. A. Cardenas
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  7. A. Martinez de Aragon
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Correspondence to A. Hilario.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Hilario, A., Salvador, E., Cardenas, A. et al. Low rCBV values in glioblastoma tumor progression under chemoradiotherapy. Neuroradiology 66, 317–323 (2024). https://doi.org/10.1007/s00234-023-03279-7

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  • DOI: https://doi.org/10.1007/s00234-023-03279-7

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