Current Concepts in Brain Tumor Imaging

2012 ◽  
pp. 119-124
Author(s):  
Andrew D. Norden ◽  
Whitney B. Pope ◽  
Susan M. Chang
Keyword(s):  
Standard Treatment ◽  
Tumor Imaging ◽  
High Grade Glioma ◽  
Response Assessment ◽  
Recurrent Glioblastoma ◽  
High Grade ◽  
Resonance Imaging ◽  
Imaging Tool ◽  
Magnetic Resonance Imaging Mri ◽  
New Criteria

Overview: Magnetic resonance imaging (MRI) is the most useful imaging tool in the evaluation of patients with brain tumors. Most information is supplied by standard anatomic images that were developed in the 1980s and 1990s. More recently, functional imaging including diffusion and perfusion MRI has been investigated as a way to generate predictive and prognostic biomarkers for high-grade glioma evaluation, but additional research is needed to establish the added benefits of these indices to standard MRI. Response critieria for high-grade gliomas have recently been updated by the Response Assessment in Neuro-Oncology (RANO) working group. The new criteria account for nonenhancing tumor in addition to the contrast-enhancing abnormalities on which older criteria relied. This issue has recently come to the fore with the introduction of the antiangiogenic agent bevacizumab into standard treatment for recurrent glioblastoma. Because of its potent antipermeability effect, contrast enhancement is markedly reduced in patients who receive bevacizumab. The RANO criteria also address the phenomenon of pseudoprogression, in which there may be transient MRI worsening of a glioblastoma following concurrent radiotherapy and temozolomide.

Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

2019 ◽  
Vol 12 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Laura Evangelista ◽  
Lea Cuppari ◽  
Luisa Bellu ◽  
Daniele Bertin ◽  
Mario Caccese ◽  
...  
Keyword(s):  
Case Series ◽  
High Grade Glioma ◽  
High Grade ◽  
True Negative ◽  
Fet Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of ◽  
Sensitivity Specificity

Purpose: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG. Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data. Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%. Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

The Reliability of Measuring Early Brain Edema with Computed Tomography

2021 ◽  
Vol 17 ◽  
Author(s):  
Yi-Fang Fan ◽  
Mi Shen ◽  
Xin-Xin Wang ◽  
Xiao-Yuan Liu ◽  
Yu-Ming Peng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Brain Edema ◽  
Early Stage ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Region Of Interest ◽  
High Grade Glioma ◽  
High Grade ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Background: Postoperative brain edema is a common complication in patients with high-grade glioma after craniotomy. Both computed tomography (CT) and Magnetic Resonance Imaging (MRI) are applied to diagnose brain edema. Usually, MRI is considered to be better than CT for identifying brain edema. However, MRI is not generally applied in diagnosing acute cerebral edema in the early postoperative stage. Whether CT is reliable in detecting postoperative brain edema in the early stage is unknown. Objective: To investigate the agreement and correlation between CT and MRI for measuring early postoperative brain edema. Methods: Patients with high-grade glioma who underwent craniotomy in Beijing Tiantan hospital from January 2017 to October 2018 were retrospectively analyzed. The region of interest and operative cavity were manually outlined, and the volume of postoperative brain edema was measured on CT and MRI. Pearson correlation testing and the intraclass correlation coefficient (ICC) were used to evaluate the association and agreement between CT and MRI for detecting the volume of postoperative brain edema. Results: Twenty patients were included in this study. The interrater agreement was perfect for detecting brain edema (CT: κ=1, ICC=0.977, P<0.001; MRI: κ=0.866, ICC=0.963, P<0.001). A significant positive correlation and excellent consistency between CT and MRI were found for measuring the volume of brain edema (rater 1: r=0.97, ICC=0.934, P<0.001; rater 2: r=0.97, ICC=0.957, P<0.001). Conclusion: Substantial comparability between CT and MRI is demonstrated for detecting postoperative brain edema. It is reliable to use CT for measuring brain edema volume in the early stage after surgery.

scholarly journals A Pilot Study of Vaccine Therapy with Multiple Glioma Oncoantigen/Glioma Angiogenesis-Associated Antigen Peptides for Patients with Recurrent/Progressive High-Grade Glioma

2019 ◽  
Vol 8 (2) ◽  
pp. 263 ◽  
Author(s):  
Ryogo Kikuchi ◽  
Ryo Ueda ◽  
Katsuya Saito ◽  
Shunsuke Shibao ◽  
Hideaki Nagashima ◽  
...  
Keyword(s):  
T Lymphocyte ◽  
High Grade Glioma ◽  
Complete Response ◽  
Recurrent Glioblastoma ◽  
Vaccine Therapy ◽  
High Grade ◽  
Peptide Epitopes ◽  
Dismal Prognosis ◽  
Multiple Glioma ◽  
Lymphocyte Responses

High-grade gliomas (HGGs) carry a dismal prognosis despite current treatments. We previously confirmed the safety and immunogenicity of a vaccine treatment targeting tumor angiogenesis with synthetic peptides, for vascular endothelial growth factor receptor (VEGFR) epitopes in recurrent HGG patients. In this study, we evaluated a novel vaccine therapy targeting not only tumor vasculature but also tumor cells, using multiple glioma oncoantigen (GOA)/glioma angiogenesis-associated antigen (GAAA) peptides in HLA-A2402+ recurrent/progressive HGG patients. The vaccine included peptide epitopes from four GOAs (LY6K, DEPDC1, KIF20A, and FOXM1) and two GAAAs (VEGFR1 and VEGFR2). Ten patients received subcutaneous vaccinations. The primary endpoint was the safety of the treatment. T-lymphocyte responses against GOA/GAAA epitopes and treatment response were evaluated secondarily. The treatment was well tolerated without any severe systemic adverse events. The vaccinations induced immunoreactivity to at least three vaccine-targeted GOA/GAAA in all six evaluable patients. The median overall survival time in all patients was 9.2 months. Five achieved progression-free status lasting at least six months. Two recurrent glioblastoma patients demonstrated stable disease. One patient with anaplastic oligoastrocytoma achieved complete response nine months after the vaccination. Taken together, this regimen was well tolerated and induced robust GOA/GAAA-specific T-lymphocyte responses in recurrent/progressive HGG patients.

scholarly journals Current standards and new concepts in MRI and PET response assessment of antiangiogenic therapies in high-grade glioma patients

2014 ◽  
Vol 17 (6) ◽  
pp. 784-800 ◽  
Author(s):  
M. Hutterer ◽  
E. Hattingen ◽  
C. Palm ◽  
M. A. Proescholdt ◽  
P. Hau
Keyword(s):  
High Grade Glioma ◽  
Response Assessment ◽  
High Grade ◽  
Antiangiogenic Therapies ◽  
New Concepts ◽  
Current Standards

scholarly journals Bevacizumab in recurrent high-grade glioma: a single institution retrospective analysis on 92 patients

2021 ◽  
Author(s):  
Beatrice Detti ◽  
Silvia Scoccianti ◽  
Maria Ausilia Teriaca ◽  
Virginia Maragna ◽  
Victoria Lorenzetti ◽  
...  
Keyword(s):  
Recurrent Disease ◽  
Performance Status ◽  
High Grade Glioma ◽  
Recurrent Glioblastoma ◽  
High Grade ◽  
Two Phase ◽  
Primary Tumors ◽  
Entire Cohort ◽  
Bevacizumab Treatment ◽  
High Grade Gliomas

Abstract Background High-grade gliomas are among the most aggressive central nervous system primary tumors, with a high risk of recurrence and a poor prognosis. Re-operation, re-irradiation, chemotherapy are options in this setting. No-best therapy has been established. Bevacizumab was approved on the basis of two Phase 2 trials that evaluated its efficacy in patients with recurrent glioblastoma. Materials and methods We have retrospectively review data of patients with high-grade glioma treated at our institution that undergone radiological or histological progression after at least one systemic treatment for recurrent disease. Bevacizumab was administered alone or in combination with chemotherapy until disease progression or unacceptable toxicity. Bevacizumab regimen was analyzed to assess PFS and OS. Histological, molecular and clinical features of the entire cohort were collected. Results We reviewed data from 92 patients, treated from April 2009 to November 2019, with histologically confirmed diagnosis of high-grade gliomas and recurrent disease. A PFS of 55.2%, 22.9% and 9.6% was observed at 6, 12 and 24 months, respectively. Performance status, age at diagnosis (< 65 or > 65 ys.) and use of corticosteroids during bevacizumab therapy were strongly associated with PFS. The OS was 74.9% at 6 months, 31.7% at 12 months, 10.1% at 24 months. In our cohort, 51.1% were long-term responders (PFS > 6 months). Globally, bevacizumab treatment was well tolerated. Conclusion Our analysis confirms the efficacy of bevacizumab in recurrent high-grade glioma patients with an acceptable toxicity profile, in keeping with its known safety in the literature.

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