The Utility of Diffusion and Perfusion Magnetic Resonance Imaging in Target Delineation of High-Grade Gliomas.

Qian Fei,Wen-Jie Guo,Xia He,Zhen Guo,Li Yin,Peng-Wei Yan,Xiu-Hua Bian,Lu-Xi Qian,Pu-Dong Qian,Ting-Ting Wang,Yu-Jie Zhang

doi:10.1155/2020/8718097

Qian Fei, Wen-Jie Guo + Show 9 more

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https://doi.org/10.1155/2020/8718097

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Abstract

Background The tumor volume of high-grade glioma (HGG) after surgery is usually determined by contrast-enhanced MRI (CE-MRI), but the clinical target volume remains controversial. Functional magnetic resonance imaging (multimodality MRI) techniques such as magnetic resonance perfusion-weighted imaging (PWI) and diffusion-tensor imaging (DTI) can make up for CE-MRI. This study explored the survival outcomes and failure patterns of patients with HGG by comparing the combination of multimodality MRI and CE-MRI imaging with CE-MRI alone. Methods 102 patients with postoperative HGG between 2012 and 2016 were included. 50 were delineated based on multimodality MRI (PWI, DTI) and CE-MRI (enhanced T1), and the other 52 were delineated based on CE-MRI as control. Results The median survival benefit was 6 months. The 2-year overall survival, progression-free survival, and local–regional control rates were 48% vs. 25%, 42% vs. 13.46%, and 40% vs. 13.46% for the multimodality MRI and CE-MRI cohorts, respectively. The two cohorts had similar rates of disease progression and recurrence but different proportions of failure patterns. The univariate analysis shows that characteristics of patients such as combined with epilepsy, the dose of radiotherapy, the selection of MRI were significant influence factors for 2-year overall survival. However, in multivariate analyses, only the selection of MRI was an independent significant predictor of overall survival. Conclusions This study was the first to explore the clinical value of multimodality MRI in the delineation of radiotherapy target volume for HGG. The conclusions of the study have positive reference significance to the combination of multimodality MRI and CE-MRI in guiding the delineation of the radiotherapy target area for HGG patients.

Highlights

Gliomas are the most common diseases in primary intracranial tumors [1], and high-grade gliomas (HGG), which are known as malignant gliomas (WHO grades III-IV) [2], account for approximately 85% of primary malignant brain tumors [3]
Some studies indicated that the clinician can capture subtle changes, such as integrity damage and diffusivity changes caused by peritumoral edema or tumor infiltration, in neuronal structures and fibers through multimodality MRI [29,30,31,32,33]
This study is the first to describe the clinical value of multimodality MRI in the delineation of the radiotherapy target volume for HGG

Summary

Introduction

Gliomas are the most common diseases in primary intracranial tumors [1], and high-grade gliomas (HGG), which are known as malignant gliomas (WHO grades III-IV) [2], account for approximately 85% of primary malignant brain tumors [3]. Cranial MRI is the most widely used imaging method in the delineation of the radiotherapy target volume with postoperative HGG [9, 10]. This study explored the survival outcomes and failure patterns of patients with HGG by comparing the combination of multimodality MRI and CE-MRI imaging with CE-MRI alone. The univariate analysis shows that characteristics of patients such as combined with epilepsy, the dose of radiotherapy, the selection of MRI were significant influence factors for 2-year overall survival. This study was the first to explore the clinical value of multimodality MRI in the delineation of radiotherapy target volume for HGG. The conclusions of the study have positive reference significance to the combination of multimodality MRI and CE-MRI in guiding the delineation of the radiotherapy target area for HGG patients

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Conclusion