Advanced

Prospective analysis of parametric response map-derived MRI biomarkers: : identification of early and distinct glioma response patterns not predicted by standard radiographic assessment

Galbán, Craig J; Chenevert, Thomas L; Meyer, Charles R; Tsien, Christina; Lawrence, Theodore S; Hamstra, Daniel A; Junck, Larry; Sundgren, Pia C LU ; Johnson, Timothy D and Galbán, Stefanie, et al. (2011) In Clinical Cancer Research 17(14). p.60-4751
Abstract

PURPOSE: Currently, radiologic response of brain tumors is assessed according to the Macdonald criteria 10 weeks from the start of therapy. There exists a critical need to identify nonresponding patients early in the course of their therapy for consideration of alternative treatment strategies. Our study assessed the effectiveness of the parametric response map (PRM) imaging biomarker to provide for an earlier measure of patient survival prediction.

EXPERIMENTAL DESIGN: Forty-five high-grade glioma patients received concurrent chemoradiation. Quantitative MRI including apparent diffusion coefficient (ADC) and relative cerebral blood volume (rCBV) maps were acquired pretreatment and 3 weeks midtreatment on a prospective... (More)

PURPOSE: Currently, radiologic response of brain tumors is assessed according to the Macdonald criteria 10 weeks from the start of therapy. There exists a critical need to identify nonresponding patients early in the course of their therapy for consideration of alternative treatment strategies. Our study assessed the effectiveness of the parametric response map (PRM) imaging biomarker to provide for an earlier measure of patient survival prediction.

EXPERIMENTAL DESIGN: Forty-five high-grade glioma patients received concurrent chemoradiation. Quantitative MRI including apparent diffusion coefficient (ADC) and relative cerebral blood volume (rCBV) maps were acquired pretreatment and 3 weeks midtreatment on a prospective institutional-approved study. PRM, a voxel-by-voxel image analysis method, was evaluated as an early prognostic biomarker of overall survival. Clinical and conventional MR parameters were also evaluated.

RESULTS: Multivariate analysis showed that PRM(ADC+) in combination with PRM(rCBV-) obtained at week 3 had a stronger correlation to 1-year and overall survival rates than any baseline clinical or treatment response imaging metric. The composite biomarker identified three distinct patient groups, nonresponders [median survival (MS) of 5.5 months, 95% CI: 4.4-6.6 months], partial responders (MS of 16 months, 95% CI: 8.6-23.4 months), and responders (MS has not yet been reached).

CONCLUSIONS: Inclusion of PRM(ADC+) and PRM(rCBV-) into a single imaging biomarker metric provided early identification of patients resistant to standard chemoradiation. In comparison to the current standard of assessment of response at 10 weeks (Macdonald criteria), the composite PRM biomarker potentially provides a useful opportunity for clinicians to identify patients who may benefit from alternative treatment strategies.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
publishing date
type
Contribution to journal
publication status
published
keywords
Biomarkers, Brain Neoplasms, Glioma, Humans, Kaplan-Meier Estimate, Magnetic Resonance Imaging, Middle Aged, Models, Statistical, Neoplasm Staging, Prognosis, Prospective Studies
in
Clinical Cancer Research
volume
17
issue
14
pages
10 pages
publisher
American Association for Cancer Research
external identifiers
  • scopus:79960411354
ISSN
1078-0432
DOI
10.1158/1078-0432.CCR-10-2098
language
English
LU publication?
no
id
3c88a62f-095e-4c35-98ef-9359e4b7157e
date added to LUP
2016-04-20 13:08:53
date last changed
2017-06-18 04:54:53
@article{3c88a62f-095e-4c35-98ef-9359e4b7157e,
  abstract     = {<p>PURPOSE: Currently, radiologic response of brain tumors is assessed according to the Macdonald criteria 10 weeks from the start of therapy. There exists a critical need to identify nonresponding patients early in the course of their therapy for consideration of alternative treatment strategies. Our study assessed the effectiveness of the parametric response map (PRM) imaging biomarker to provide for an earlier measure of patient survival prediction.</p><p>EXPERIMENTAL DESIGN: Forty-five high-grade glioma patients received concurrent chemoradiation. Quantitative MRI including apparent diffusion coefficient (ADC) and relative cerebral blood volume (rCBV) maps were acquired pretreatment and 3 weeks midtreatment on a prospective institutional-approved study. PRM, a voxel-by-voxel image analysis method, was evaluated as an early prognostic biomarker of overall survival. Clinical and conventional MR parameters were also evaluated.</p><p>RESULTS: Multivariate analysis showed that PRM(ADC+) in combination with PRM(rCBV-) obtained at week 3 had a stronger correlation to 1-year and overall survival rates than any baseline clinical or treatment response imaging metric. The composite biomarker identified three distinct patient groups, nonresponders [median survival (MS) of 5.5 months, 95% CI: 4.4-6.6 months], partial responders (MS of 16 months, 95% CI: 8.6-23.4 months), and responders (MS has not yet been reached).</p><p>CONCLUSIONS: Inclusion of PRM(ADC+) and PRM(rCBV-) into a single imaging biomarker metric provided early identification of patients resistant to standard chemoradiation. In comparison to the current standard of assessment of response at 10 weeks (Macdonald criteria), the composite PRM biomarker potentially provides a useful opportunity for clinicians to identify patients who may benefit from alternative treatment strategies.</p>},
  author       = {Galbán, Craig J and Chenevert, Thomas L and Meyer, Charles R and Tsien, Christina and Lawrence, Theodore S and Hamstra, Daniel A and Junck, Larry and Sundgren, Pia C and Johnson, Timothy D and Galbán, Stefanie and Sebolt-Leopold, Judith S and Rehemtulla, Alnawaz and Ross, Brian D},
  issn         = {1078-0432},
  keyword      = {Biomarkers,Brain Neoplasms,Glioma,Humans,Kaplan-Meier Estimate,Magnetic Resonance Imaging,Middle Aged,Models, Statistical,Neoplasm Staging,Prognosis,Prospective Studies},
  language     = {eng},
  month        = {07},
  number       = {14},
  pages        = {60--4751},
  publisher    = {American Association for Cancer Research},
  series       = {Clinical Cancer Research},
  title        = {Prospective analysis of parametric response map-derived MRI biomarkers: : identification of early and distinct glioma response patterns not predicted by standard radiographic assessment},
  url          = {http://dx.doi.org/10.1158/1078-0432.CCR-10-2098},
  volume       = {17},
  year         = {2011},
}