Assessment of glioma response to radiotherapy using 3D pulsed-continuous arterial spin labeling and 3D segmented volume

详细信息    查看全文

• 作者：Peng Wang¹ ; Jianrui Li¹ ; Qiang Diao ; YuanKai Lin ; Jun Zhang ; Lin Li ; Gang Yang ; Xiaokun Fang ; Xie Li ; YingQi Chen ; Ling Zheng ; ^{lingzheng1989@yeah.net" class="auth_mail" title="E-mail the corresponding author} ; Guangming Lu ; ^{guangminglu1905@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ASL ; arterial spin labeling ; pcASL ; pulsed-continuous arterial spin labeling ; CBF ; cerebral blood flow ; TBF ; tumor blood flow ; TBFmean ; mean tumor blood flow ; TBFmax ; maximum tumor blood flow ; rTBF ; relative TBF ; DSC ; dynamic susceptibility contrast ; PASL ; pulsed ASL ; CASL ; continuous ASL ; SNR ; signal-to-noise ratio ; WHO ; World Health Organization ; 3D ; three dimensional ; DTI ; diffusion tensor imaging ; MRI ; magnetic resonance imaging ; MRS ; magnetic resonance spectroscopy
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：85
• 期：11
• 页码：1987-1992
• 全文大小：1054 K

文摘

Gliomas are the most common primary brain tumors in adults, in some cases, radiotherapy may be the preferred treatment option especially for elderly people who cannot endure surgery. Therefore, it is necessary to evaluate the effects of radiotherapy on glioma. Arterial spin labeling (ASL) is an MR imaging technique that allows for a quantitative determination of cerebral blood flow (CBF) noninvasively. Tumor volume is still an important determinant for evaluating treatment response. The purpose of this study was to investigate the relationship between the tumor perfusion parameters and tumor volume and assess the effects of radiotherapy on glioma using pulsed-continuous arterial spin labeling (pcASL) technique.

Methods

35 patients with gliomas, histologically classified as low-grade group (n = 16) and high-grade group (n = 19), treated with radiotherapy only or before using other therapies were included in this study. MR examinations, including T1 weighted image and pcASL, were performed before and 4, 8, 12, 16 weeks after radiotherapy. Regional CBF of normal tissue, mean tumor blood flow (TBF_mean), maximum tumor blood flow (TBF_max), and tumor volume were evaluated at each time point. Both the percentage change in CBF (CBF ratio), TBF_mean (TBF_mean ratio), TBF_max (TBF_max ratio) and the percentage change in tumor volume (volume ratio) were calculated using values obtained before and after radiotherapy. The correlation between the volume ratio and CBF ratio, TBF_mean ratio, TBF_max ratio was assessed using linear regression analysis and Pearson’s correlation.

Results

The TBF_mean and TBF_max of high-grade gliomas were significantly higher than that of low-grade group. In high-grade group, a strong correlation was demonstrated between the tumor volume and the TBF_max before radiotherapy (R² = 0.35, r_s = 0.59, p < 0.05). There was also a significant correlation between the TBF_max before radiotherapy and the tumor volume ratio before and 8 weeks after radiotherapy (R² = 0.56, r_s = −0.74, p < 0.05).

Conclusion

The TBF_max measured using pcASL could assess tumoral grade and also could become a potential tool for evaluating the therapeutic effects of radiation.