Abstract
Background: Glioblastoma is the most frequent malignant primitive brain tumor in adults. The treatment includes surgery, radiotherapy, and chemotherapy. During follow-up, combined chemoradiotherapy can induce treatment-related changes mimicking tumor progression on medical imaging, such as pseudoprogression (PsP). Differentiating PsP from true progression (TP) remains a challenge for radiologists and oncologists, who need to promptly start a second-line treatment in the case of TP. Advanced magnetic resonance imaging (MRI) techniques such as diffusion-weighted imaging, perfusion MRI, and proton magnetic resonance spectroscopic imaging are more efficient than conventional MRI in differentiating PsP from TP. None of these techniques are fully effective, but current advances in computer science and the advent of artificial intelligence are opening up new possibilities in the imaging field with radiomics (i.e., extraction of a large number of quantitative MRI features describing tumor density, texture, and geometry). These features are used to build predictive models for diagnosis, prognosis, and therapeutic response. Method: Out of 7350 records for MR spectroscopy, GBM, glioma, recurrence, diffusion, perfusion, pseudoprogression, radiomics, and advanced imaging, we screened 574 papers. A total of 228 were eligible, and we analyzed 72 of them, in order to establish the role of each imaging modality and the usefulness and limitations of radiomics analysis.
Highlights
Introduction published maps and institutional affilGlioblastoma (GBM) is the most aggressive and frequent type of primary brain tumor in adults [1], with an incidence of about 4–5/100,000 [2]
We focused on the added value of different types of advanced medical imaging when it comes to differentiating PsP from true progression (TP), as well as the role of radiomics in meeting this clinical challenge
Neither conventional magnetic resonance imaging (MRI) nor advanced techniques can formally differentiate between PsP and TP
Summary
We conducted a comprehensive search of the PubMed and Google Scholar databases to find relevant articles (published up to September 2021). The search terms were as follows: magnetic resonance spectroscopy or MR spectroscopy or MRS, GBM, glioma, recurrence, diffusion, perfusion, pseudoprogression, radiomics, and advanced imaging. Articles concerning PsP in adult patients with glioma, high-grade glioma, or GBM were examined. References provided by relevant articles were examined to identify additional studies for inclusion. Articles describing positron emission tomography imaging or animal studies or PsP treatment or machine learning on glioma without PsP as subject were excluded. A total of 228 articles and after applying exclusion criteria 72 were included. Two persons checked the data: one extracted data and an other person checked the extracted data.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
