Interventional Magnetic-Resonance-Guided Cryotherapy Combined with Microsurgery for Recurrent Glioblastoma: An Innovative Treatment?

2021 ◽  
Author(s):  
Helene Cebula ◽  
Julien Garnon ◽  
Julien Todeschi ◽  
Georges Noel ◽  
Benoit Lhermitte ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Recurrent Glioblastoma ◽  
Innovative Treatment

scholarly journals Diffusion Magnetic Resonance Imaging Phenotypes Predict Overall Survival Benefit From Bevacizumab or Surgery in Recurrent Glioblastoma With Large Tumor Burden

Neurosurgery ◽  
2020 ◽  
Vol 87 (5) ◽  
pp. 931-938 ◽  
Author(s):  
Kunal S Patel ◽  
Richard G Everson ◽  
Jingwen Yao ◽  
Catalina Raymond ◽  
Jodi Goldman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Magnetic Resonance ◽  
Large Volume ◽  
Survival Benefit ◽  
Tumor Burden ◽  
Recurrent Glioblastoma ◽  
Large Tumor ◽  
Diffusion Mr ◽  
Large Tumor Burden ◽  
Mr Characteristics

Abstract Background Diffusion magnetic resonance (MR) characteristics are a predictive imaging biomarker for survival benefit in recurrent glioblastoma treated with anti-vascular endothelial growth factor (VEGF) therapy; however, its use in large volume recurrence has not been evaluated. Objective To determine if diffusion MR characteristics can predict survival outcomes in patients with large volume recurrent glioblastoma treated with bevacizumab or repeat resection. Methods A total of 32 patients with large volume (>20 cc or > 3.4 cm diameter) recurrent glioblastoma treated with bevacizumab and 35 patients treated with repeat surgery were included. Pretreatment tumor volume and apparent diffusion coefficient (ADC) histogram analysis were used to phenotype patients as having high (>1.24 μm2/ms) or low (<1.24 μm2/ms) ADCL, the mean value of the lower peak in a double Gaussian model of the ADC histogram within the contrast enhancing tumor. Results In bevacizumab and surgical cohorts, volume was correlated with overall survival (Bevacizumab: P = .009, HR = 1.02; Surgical: P = .006, HR = 0.96). ADCL was an independent predictor of survival in the bevacizumab cohort (P = .049, HR = 0.44), but not the surgical cohort (P = .273, HR = 0.67). There was a survival advantage of surgery over bevacizumab in patients with low ADCL (P = .036, HR = 0.43) but not in patients with high ADCL (P = .284, HR = 0.69). Conclusion Pretreatment diffusion MR imaging is an independent predictive biomarker for overall survival in recurrent glioblastoma with a large tumor burden. Large tumors with low ADCL have a survival benefit when treated with surgical resection, whereas large tumors with high ADCL may be best managed with bevacizumab.

111 Magnetic Resonance Spectroscopic Imaging Measurement of Early Response to Vorinostat Treatment in Recurrent Glioblastoma

Neurosurgery ◽  
2012 ◽  
Vol 71 (2) ◽  
pp. E546-E547
Author(s):  
Jeffrey J. Olson ◽  
Alfredo Voloschin ◽  
Li Wei ◽  
Andrew Miller ◽  
Daniel Brat ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Spectroscopic Imaging ◽  
Early Response ◽  
Recurrent Glioblastoma ◽  
Magnetic Resonance Spectroscopic Imaging

scholarly journals Recurrent glioblastoma: Volumetric assessment and stratification of patient survival with early posttreatment magnetic resonance imaging in patients treated with bevacizumab

Cancer ◽  
2013 ◽  
Vol 119 (19) ◽  
pp. 3479-3488 ◽  
Author(s):  
Raymond Y. Huang ◽  
Rifaquat Rahman ◽  
Alhafidz Hamdan ◽  
Caroline Kane ◽  
Christina Chen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Patient Survival ◽  
Recurrent Glioblastoma ◽  
Resonance Imaging ◽  
Volumetric Assessment

scholarly journals CTNI-48. NOVEL TREATMENT OF END STAGE RECURRENT GLIOBLASTOMA TREATED WITH A NONINVASIVE ONCOMAGNETIC DEVICE USING OSCILLATING MAGNETIC FIELDS – A NEW AND POWERFUL NONINVASIVE THERAPY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii53-ii53
Author(s):  
Santosh Helekar ◽  
Martyn Sharpe ◽  
Kumar Pichumani ◽  
Omkar Ijare ◽  
Lisa Nguyen ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Fields ◽  
Electric Fields ◽  
Standard Of Care ◽  
Surgical Excision ◽  
Recurrent Glioblastoma ◽  
Noninvasive Treatment ◽  
Pre Treatment ◽  
End Stage

Abstract Noninvasive treatment with alternating electric fields at 200 kHz (Optune therapy) has been approved for recurrent and newly diagnosed glioblastoma (GBM). We have recently tested and confirmed in vitro, and in patient derived xenografted mouse models, the oncolytic potential of powerful newly developed device generating oscillating magnetic fields (OMF) using rotating magnets. This device is completely different and has different mechanisms of action than Optune therapy. We report the successful treatment of an endstage recurrent GBM in a 53-year-old man. The patient had undergone radical surgical excision and standard of care chemoradiotherapy, as well as experimental gene therapy for a left frontal tumor. 18 months after this treatment, there was recurrence with progressive enlargement and leptomeningeal spread, making the patient’s condition not suitable for further treatment. We conducted a 5-week treatment (followed by a pause of one week) consisting of daily exposure (on weekdays) with intermittent OMF. The patient tolerated the treatment well. At 4 weeks there was a progressive reduction of the contrast-enhanced tumor (CET) volume to less than 60% of the pre-treatment volume on magnetic resonance imaging scans. Caregiver report indicated mild subjective improvement in speech and cognitive function. The daily decrease in volume was correlated with the amount of daily treatment, with longer treatments showing an increase in shrinkage of the CET volume. After the treatment pause in the 6th week, there was an apparent increase in CET volume. However, a marked reduction in the choline peak and an increase in the lipid peak on a proton magnetic resonance spectrogram of the tumor at this timepoint documented that this represented necrotic tissue. We are excited about this new and powerful treatment for glioblastoma and will present the details of treatment and imaging studies during therapy.

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