The experience of using ASL perfusion in the differential diagnosis of brain changes in patients with glioblastoma (Grade IV) in the postoperative period before and after radiation therapy.

Congress:

ECR 2020

Poster Number:

C-10423

Type:

Scientific Exhibit

Keywords:

Radiotherapy techniques, Neoplasia, Surgery, Radiation therapy / Oncology, Contrast agent-intravenous, MR-Diffusion/Perfusion, MR, Oncology, Neuroradiology brain, Head and neck, Oncologic Imaging, Prospective, Diagnostic or prognostic study, Performed at one institution

Authors:

M. Bunak, M. Vishnyakova, A. Abramenko, G. V. Chermensky; Moscow/RU

DOI:

10.26044/ecr2020/C-10423

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-10423

Fig. 1: Regions of interest (ROI) in brain tissue in patients after surgery. ROI 1 -...

Fig. 2: Case #1. The visualization of residual tumor tissue after surgery and the...

Fig. 4: Case #3. The visualization of residual tumor tissue after surgery and absence...

Fig. 3: Case #2. Positive dynamics of CBF decline in the region of interest after...

Purpose

The diagnosis and treatment of high-grade gliomas is a difficult task due to their tendency to continued growth. It is often accompanied by the impaired blood-brain barrier (1, 2). The combined approach in glioblastoma's treatment, including surgery, radiation, and chemotherapy, complicates its diagnosis even more (3). The destruction of the blood-brain barrier after treatment is also noted. So, the accumulation of a contrast agent in all cases makes it difficult to differentiate the residual tumor tissue against the background of postoperative and radiation injuries in...

Methods and materials

We measured the CBF value in presumed tumor tissue in patients with histologically verified glioblastoma (GRADE IV) right after surgical resection before radiotherapy and repeated 3-4 months after radiotherapy. 63 patients were examined initially – 36 men (57,1%) and 27 women (42,9%). The average age of patients was 56,8±11,1 years (min- 31 years, max- 80 years), there were no significant differences in age between the examined men and women (56.2 ± 11.5 years in men, 57.5 ± 10.9 years in women, p = 0.52). MRI...

Results

All patients were divided into 2 groups according to CBF value on the first visit. 1st group: 41 patients (65.1%) with high level of perfusion in ROI 1 (in presumed tumor tissue), the average CBF there was 135,4±41,3 ml / 100 g / min (min - 73.9, max - 255.9). After radiotherapy 20 patients returned. 15 of them (75%) had decreased CBF about 40-60% in previous tumor area (65,7±35,3 compared 138,8±33,8 ml / 100 g / min on first visit).Fig. 2,Fig. 3,Fig. 4 But there...

Conclusion

In our study we showed the evaluation of CBF is enough to identify residual tumor tissue against the background of postoperative and radiation injuries in the brain. So we can conclude that ASL perfusion in addition to contrast MRI- methods increase the possibility of differential diagnosis of brain changes in patients with glioblastoma in different periods after radiotherapy.

Personal information and conflict of interest

M. Bunak; Moscow/RU - nothing to disclose M. Vishnyakova; Moscow/RU - nothing to disclose A. S. Abramenko; Moscow/RU - nothing to disclose G. V. Chermensky; Moscow/RU - nothing to disclose

References

1. Luiz Gustavo Dubois, Loraine Campanati, Cassia Righy, Isabella D’Andrea-Meira, Tania Cristina Leite de Sampaio e Spohr.Gliomas and the vascular fragility of the blood brain barrier. Front. Cell. Neurosci., 12 December 2014 2. Huang AP, Tsai JC, Kuo LT, Lee CW, Lai HS, Tsai LK, Huang SJ, Chen CM, Chen YS, Chuang HY, Wintermark M. Clinical application of perfusion computed tomography in neurosurgery. J Neurosurg 120: 473 488, 2014 3. Chen Y., Trotti A., Coleman C. et al. Adverse event reporting and developments in radiation...