Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Dynamic Susceptibility Contrast-Enhanced Perfusion Magnetic Resonance (MR) Imaging Combined with Contrast-Enhanced MR Imaging in the Follow-up of Immunogene-Treated Glioblastoma Multiforme.

Stenberg, Lars LU ; Englund, Elisabet LU orcid ; Wirestam, Ronnie LU orcid ; Siesjö, Peter LU orcid ; Salford, Leif LU and Larsson, Elna-Marie LU (2006) In Acta Radiologica 47(8). p.852-861
Abstract
Purpose: To assess the value of the combined use of dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging (MRI) and conventional contrast-enhanced MRI for the follow-up of treatment of glioblastoma multiforme (GBM). Material and Methods: 79 examinations were performed in six surgically and immunogene-treated patients and two surgically treated patients. Ratios of the relative cerebral blood volume (rCBV) in lesions and in the contralateral normal-appearing white matter were calculated. The regions with elevated rCBV were compared with those with contrast enhancement. Tissue specimens from surgical biopsies and autopsies were studied histopathologically. Results: The lesion-to-normal rCBV ratios were high in the... (More)
Purpose: To assess the value of the combined use of dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging (MRI) and conventional contrast-enhanced MRI for the follow-up of treatment of glioblastoma multiforme (GBM). Material and Methods: 79 examinations were performed in six surgically and immunogene-treated patients and two surgically treated patients. Ratios of the relative cerebral blood volume (rCBV) in lesions and in the contralateral normal-appearing white matter were calculated. The regions with elevated rCBV were compared with those with contrast enhancement. Tissue specimens from surgical biopsies and autopsies were studied histopathologically. Results: The lesion-to-normal rCBV ratios were high in the tumors prior to operation (7.3 to 18.2) as well as in the recurrent tumors (1.6 to 13.2). The volumes of the regions with elevated rCBV were similar to those with contrast enhancement in 63 of the 79 examinations. However, in 11 of 79 examinations, the regions with high rCBV were smaller than the regions with contrast enhancement ("mismatch"). In two samples from the immunogene-treated patients this was correlated with the histopathological finding of malignant tumor with numerous proliferating GBM vessels with multiple minimal lumina, sometimes thrombotized or ruptured. These vessels may have increased permeability with contrast enhancement not accompanied by increased microvascular volume. Conclusion: 1) Elevated rCBV on perfusion MRI corresponding to the contrast-enhancing lesion supports the diagnosis of recurrent malignant tumor. 2) A mismatch showing a volume of rCBV elevation smaller than that of contrast enhancement can be seen in particularly aggressive tumor growth and is thus not always a sign of reactive non-tumor changes. 3) The combination of perfusion MRI and conventional contrast MRI provides useful information in the follow-up of glioblastoma multiforme treatment. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
perfusion MR, brain tumor, glioblastoma multiforme, immunogene treatment, magnetic, resonance imaging
in
Acta Radiologica
volume
47
issue
8
pages
852 - 861
publisher
SAGE Publications
external identifiers
  • wos:000242362100017
  • scopus:33749485366
  • pmid:17050367
ISSN
1600-0455
DOI
10.1080/02841850600815341
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Neurosurgery (013026000), Diagnostic Radiology, (Lund) (013038000), Pathology, (Lund) (013030000), Radiation Physics, Lund (013034000)
id
f4e9b4ab-0ccd-45e0-994d-bd1fd51c1805 (old id 162270)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17050367&dopt=Abstract
date added to LUP
2016-04-01 16:32:54
date last changed
2021-08-04 03:36:58
@article{f4e9b4ab-0ccd-45e0-994d-bd1fd51c1805,
  abstract     = {Purpose: To assess the value of the combined use of dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging (MRI) and conventional contrast-enhanced MRI for the follow-up of treatment of glioblastoma multiforme (GBM). Material and Methods: 79 examinations were performed in six surgically and immunogene-treated patients and two surgically treated patients. Ratios of the relative cerebral blood volume (rCBV) in lesions and in the contralateral normal-appearing white matter were calculated. The regions with elevated rCBV were compared with those with contrast enhancement. Tissue specimens from surgical biopsies and autopsies were studied histopathologically. Results: The lesion-to-normal rCBV ratios were high in the tumors prior to operation (7.3 to 18.2) as well as in the recurrent tumors (1.6 to 13.2). The volumes of the regions with elevated rCBV were similar to those with contrast enhancement in 63 of the 79 examinations. However, in 11 of 79 examinations, the regions with high rCBV were smaller than the regions with contrast enhancement ("mismatch"). In two samples from the immunogene-treated patients this was correlated with the histopathological finding of malignant tumor with numerous proliferating GBM vessels with multiple minimal lumina, sometimes thrombotized or ruptured. These vessels may have increased permeability with contrast enhancement not accompanied by increased microvascular volume. Conclusion: 1) Elevated rCBV on perfusion MRI corresponding to the contrast-enhancing lesion supports the diagnosis of recurrent malignant tumor. 2) A mismatch showing a volume of rCBV elevation smaller than that of contrast enhancement can be seen in particularly aggressive tumor growth and is thus not always a sign of reactive non-tumor changes. 3) The combination of perfusion MRI and conventional contrast MRI provides useful information in the follow-up of glioblastoma multiforme treatment.},
  author       = {Stenberg, Lars and Englund, Elisabet and Wirestam, Ronnie and Siesjö, Peter and Salford, Leif and Larsson, Elna-Marie},
  issn         = {1600-0455},
  language     = {eng},
  number       = {8},
  pages        = {852--861},
  publisher    = {SAGE Publications},
  series       = {Acta Radiologica},
  title        = {Dynamic Susceptibility Contrast-Enhanced Perfusion Magnetic Resonance (MR) Imaging Combined with Contrast-Enhanced MR Imaging in the Follow-up of Immunogene-Treated Glioblastoma Multiforme.},
  url          = {http://dx.doi.org/10.1080/02841850600815341},
  doi          = {10.1080/02841850600815341},
  volume       = {47},
  year         = {2006},
}