Parametric response maps of perfusion MRI may identify recurrent glioblastomas responsive to bevacizumab and irinotecan

Domenico Aquino, Anna Luisa Di Stefano, Alessandro Scotti, Lucia Cuppini, Elena Anghileri, Gaetano Finocchiaro, Maria Grazia Bruzzone, Marica Eoli

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Perfusion weighted imaging (PWI) can be used to measure key aspects of tumor vascularity in vivo and recent studies suggest that perfusion imaging may be useful in the early assessment of response to angiogenesis inhibitors. Aim of this work is to compare Parametric Response Maps (PRMs) with the Region Of Interest (ROI) approach in the analysis of tumor changes induced by bevacizumab and irinotecan in recurrent glioblastomas (rGBM), and to evaluate if changes in tumor blood volume measured by perfusion MRI may predict clinical outcome. Methods: 42 rGBM patients with KPS ≥50 were treated until progression, as defined by MRI with RANO criteria. Relative cerebral blood volume (rCBV) variation after 8 weeks of treatment was calculated through semi-automatic ROI placement in the same anatomic region as in baseline. Alternatively, rCBV variations with respect to baseline were calculated into the evolving tumor region using a voxel-by-voxel difference. PRMs were created showing where rCBV significantly increased, decreased or remained unchanged. Results: An increased blood volume in PRM (PRMCBV+) higher than 18% (first quartile) after 8 weeks of treatment was associated with increased progression free survival (PFS; 24 versus 13 weeks, p = 0.045) and overall survival (OS; 38 versus 25 weeks, p = 0.016). After 8 weeks of treatment ROI analysis showed that mean rCBV remained elevated in non responsive patients (4.8±0.9 versus 5.1±1.2, p = 0.38), whereas decreased in responsive patients (4.2±1.3 versus 3.861.6 p = 0.04), and re-increased progressively when patients approached tumor progression. Conclusions: Our data suggest that PRMs can provide an early marker of response to antiangiogenic treatment and warrant further confirmation in a larger cohort of GBM patients.

Original languageEnglish
Article numbere90535
JournalPLoS One
Volume9
Issue number3
DOIs
Publication statusPublished - Mar 27 2014

Fingerprint

irinotecan
blood volume
Glioblastoma
Magnetic resonance imaging
Blood
Perfusion
Tumors
neoplasms
Perfusion Imaging
Blood Volume
Neoplasms
image analysis
Angiogenesis Inhibitors
Imaging techniques
Therapeutics
Tumor Burden
Disease-Free Survival
angiogenesis
Bevacizumab

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Parametric response maps of perfusion MRI may identify recurrent glioblastomas responsive to bevacizumab and irinotecan. / Aquino, Domenico; Di Stefano, Anna Luisa; Scotti, Alessandro; Cuppini, Lucia; Anghileri, Elena; Finocchiaro, Gaetano; Bruzzone, Maria Grazia; Eoli, Marica.

In: PLoS One, Vol. 9, No. 3, e90535, 27.03.2014.

Research output: Contribution to journalArticle

@article{a16909ebb3134ed6a866ec405eb9ef75,
title = "Parametric response maps of perfusion MRI may identify recurrent glioblastomas responsive to bevacizumab and irinotecan",
abstract = "Background: Perfusion weighted imaging (PWI) can be used to measure key aspects of tumor vascularity in vivo and recent studies suggest that perfusion imaging may be useful in the early assessment of response to angiogenesis inhibitors. Aim of this work is to compare Parametric Response Maps (PRMs) with the Region Of Interest (ROI) approach in the analysis of tumor changes induced by bevacizumab and irinotecan in recurrent glioblastomas (rGBM), and to evaluate if changes in tumor blood volume measured by perfusion MRI may predict clinical outcome. Methods: 42 rGBM patients with KPS ≥50 were treated until progression, as defined by MRI with RANO criteria. Relative cerebral blood volume (rCBV) variation after 8 weeks of treatment was calculated through semi-automatic ROI placement in the same anatomic region as in baseline. Alternatively, rCBV variations with respect to baseline were calculated into the evolving tumor region using a voxel-by-voxel difference. PRMs were created showing where rCBV significantly increased, decreased or remained unchanged. Results: An increased blood volume in PRM (PRMCBV+) higher than 18{\%} (first quartile) after 8 weeks of treatment was associated with increased progression free survival (PFS; 24 versus 13 weeks, p = 0.045) and overall survival (OS; 38 versus 25 weeks, p = 0.016). After 8 weeks of treatment ROI analysis showed that mean rCBV remained elevated in non responsive patients (4.8±0.9 versus 5.1±1.2, p = 0.38), whereas decreased in responsive patients (4.2±1.3 versus 3.861.6 p = 0.04), and re-increased progressively when patients approached tumor progression. Conclusions: Our data suggest that PRMs can provide an early marker of response to antiangiogenic treatment and warrant further confirmation in a larger cohort of GBM patients.",
author = "Domenico Aquino and {Di Stefano}, {Anna Luisa} and Alessandro Scotti and Lucia Cuppini and Elena Anghileri and Gaetano Finocchiaro and Bruzzone, {Maria Grazia} and Marica Eoli",
year = "2014",
month = "3",
day = "27",
doi = "10.1371/journal.pone.0090535",
language = "English",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

}

TY - JOUR

T1 - Parametric response maps of perfusion MRI may identify recurrent glioblastomas responsive to bevacizumab and irinotecan

AU - Aquino, Domenico

AU - Di Stefano, Anna Luisa

AU - Scotti, Alessandro

AU - Cuppini, Lucia

AU - Anghileri, Elena

AU - Finocchiaro, Gaetano

AU - Bruzzone, Maria Grazia

AU - Eoli, Marica

PY - 2014/3/27

Y1 - 2014/3/27

N2 - Background: Perfusion weighted imaging (PWI) can be used to measure key aspects of tumor vascularity in vivo and recent studies suggest that perfusion imaging may be useful in the early assessment of response to angiogenesis inhibitors. Aim of this work is to compare Parametric Response Maps (PRMs) with the Region Of Interest (ROI) approach in the analysis of tumor changes induced by bevacizumab and irinotecan in recurrent glioblastomas (rGBM), and to evaluate if changes in tumor blood volume measured by perfusion MRI may predict clinical outcome. Methods: 42 rGBM patients with KPS ≥50 were treated until progression, as defined by MRI with RANO criteria. Relative cerebral blood volume (rCBV) variation after 8 weeks of treatment was calculated through semi-automatic ROI placement in the same anatomic region as in baseline. Alternatively, rCBV variations with respect to baseline were calculated into the evolving tumor region using a voxel-by-voxel difference. PRMs were created showing where rCBV significantly increased, decreased or remained unchanged. Results: An increased blood volume in PRM (PRMCBV+) higher than 18% (first quartile) after 8 weeks of treatment was associated with increased progression free survival (PFS; 24 versus 13 weeks, p = 0.045) and overall survival (OS; 38 versus 25 weeks, p = 0.016). After 8 weeks of treatment ROI analysis showed that mean rCBV remained elevated in non responsive patients (4.8±0.9 versus 5.1±1.2, p = 0.38), whereas decreased in responsive patients (4.2±1.3 versus 3.861.6 p = 0.04), and re-increased progressively when patients approached tumor progression. Conclusions: Our data suggest that PRMs can provide an early marker of response to antiangiogenic treatment and warrant further confirmation in a larger cohort of GBM patients.

AB - Background: Perfusion weighted imaging (PWI) can be used to measure key aspects of tumor vascularity in vivo and recent studies suggest that perfusion imaging may be useful in the early assessment of response to angiogenesis inhibitors. Aim of this work is to compare Parametric Response Maps (PRMs) with the Region Of Interest (ROI) approach in the analysis of tumor changes induced by bevacizumab and irinotecan in recurrent glioblastomas (rGBM), and to evaluate if changes in tumor blood volume measured by perfusion MRI may predict clinical outcome. Methods: 42 rGBM patients with KPS ≥50 were treated until progression, as defined by MRI with RANO criteria. Relative cerebral blood volume (rCBV) variation after 8 weeks of treatment was calculated through semi-automatic ROI placement in the same anatomic region as in baseline. Alternatively, rCBV variations with respect to baseline were calculated into the evolving tumor region using a voxel-by-voxel difference. PRMs were created showing where rCBV significantly increased, decreased or remained unchanged. Results: An increased blood volume in PRM (PRMCBV+) higher than 18% (first quartile) after 8 weeks of treatment was associated with increased progression free survival (PFS; 24 versus 13 weeks, p = 0.045) and overall survival (OS; 38 versus 25 weeks, p = 0.016). After 8 weeks of treatment ROI analysis showed that mean rCBV remained elevated in non responsive patients (4.8±0.9 versus 5.1±1.2, p = 0.38), whereas decreased in responsive patients (4.2±1.3 versus 3.861.6 p = 0.04), and re-increased progressively when patients approached tumor progression. Conclusions: Our data suggest that PRMs can provide an early marker of response to antiangiogenic treatment and warrant further confirmation in a larger cohort of GBM patients.

UR - http://www.scopus.com/inward/record.url?scp=84899842077&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899842077&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0090535

DO - 10.1371/journal.pone.0090535

M3 - Article

C2 - 24675671

AN - SCOPUS:84899842077

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 3

M1 - e90535

ER -