Nimg-58preliminary Trends in Advanced Imaging Relative to Standard Imaging in Subjects Treated With Optune
Year: 2015
Type: article
Abstract: BACKGROUND: Optune has recently received FDA approval for antimitotic treatment of subjects with recurrent glioblastoma. Response to Optune treatment is generally delayed (5.2 months) with the response duration highly correlated with OS. Recently, it was shown that 44% of responders developed initial tumor growth based on standard imaging. The aim of this preliminary analysis is to determine if there is a potential role for advanced imaging to distinguish responders from non-responders based on the directional change in MRI-derived perfusion and diffusion metrics. METHODS: Advanced MRI was examined in 7 recurrent high-grade glioma subjects (WHO IV = 4/WHO III = 3; 3M/4F) treated with Optune. When available, FLAIR (FV) and enhancing tumor volumes (ETV) were examined with diffusion (ADC) and DSC perfusion (rCBV and rCBF). Mean parameter values were obtained within FV and ETV prior to and following Optune treatment and trends in perfusion and diffusion are reported, relative to standard imaging. RESULTS: All but one subject had increased FV. In cases where FV increased, 3/4 cases had a decrease in perfusion and 2/5 cases had an increase in ADC indicating response. Half of subjects had increased ETV. In cases where ETV decreased, 2/2 subjects had an increase in perfusion and 1/3 cases had a decrease in ADC. In cases where ETV increased, 1/3 cases had a decrease in perfusion and 2/3 cases had an increase in ADC. CONCLUSIONS: Advanced imaging may potentially provide additional information beyond standard imaging, with potential to help identify early responders to Optune treatment. Additional information may be obtained through the use of advanced imaging as decreases in perfusion or increases in diffusion did not trend well with decreases in FV (≥50% case differences) or ETV (≥66% case differences). Further analysis in a larger cohort is underway, where future goals include correlation of advanced imaging to survival and device compliance.
Source: Neuro-Oncology
Institution: Medical College of Wisconsin
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2585217160