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; Englund, Elisabet; Wirestam, Ronnie; Siesjö, Peter; Salford, Leif; Larsson, Elna-Marie

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

Mark

Stenberg, Lars ^LU ; Englund, Elisabet ^LU

; Wirestam, Ronnie ^LU

; Siesjö, Peter ^LU

; 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: https://lup.lub.lu.se/record/162270

author

Stenberg, Lars ^LU ; Englund, Elisabet ^LU

; Wirestam, Ronnie ^LU

; Siesjö, Peter ^LU

; Salford, Leif ^LU and Larsson, Elna-Marie ^LU

organization

publishing date

2006

type

Contribution to journal

publication status

published

subject

Radiology, Nuclear Medicine and Medical Imaging

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

2022-02-20 06:49:28

@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}},
  keywords     = {{perfusion MR; brain tumor; glioblastoma multiforme; immunogene treatment; magnetic; resonance imaging}},
  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}},
}

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