Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener klinische Wochenschrift 21-22/2021

20.04.2021 | original article

Multimodal assessment of disease activity in glioblastoma

A single center experience

verfasst von: Alexander Tinchon, Franz Marhold, Bernadette Calabek-Wohinz, Katharina Hainz, Martina Tesar-Pelz, Gregory Minear, Elisabeth Freydl, Katrin Blauensteiner, Gertraud Heinz, MD, Prof, FEAN Stefan Oberndorfer

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2021

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Background

Assessment of disease activity in glioblastoma (GBM) can be challenging due to several clinical and radiological pitfalls. Besides MRI, FET-PET and neurocognitive assessment (NA) are used in several neuro-oncological centers in order to improve the specificity of response assessment.
We performed a retrospective study to investigate whether the assessment by RANO (Response Assessment in NeuroOncology) corresponds to FET-PET imaging and NA results. Moreover, the concordance of RANO with a final recommendation of an interdisciplinary neuro-oncological tumor board recommendation (TBR) was analyzed.

Methods

We enrolled 25 consecutive patients with newly diagnosed histologically confirmed GBM in a pilot study, accounting for 81 multimodal test results. All patients were selected after undergoing consecutive follow-up comprising MRI, FET-PET, and NA with a subsequent TBR. Results were analyzed for correlations between RANO, FET-PET and NA. An additional consistency analysis was performed to elucidate the impact of RANO on decision making.

Results

A highly statistically significant correlation was found between RANO and FET-PET and NA results (all P < 0.01); however, 26% of follow-up tests exhibited inconsistent results in multimodal assessment, among which RANO was only 48% in accordance with the final TBR. The concordance of NA and FET-PET with the final TBR was 67% and 86%, respectively.

Conclusion

The RANO proved its value in the context of multimodal assessment of disease activity in GBM; however, because the implementation of multimodal assessment showed a considerably high percentage of inconsistent results, further studies are required to investigate the relationship between different assessment techniques, in addition to their overall significance to response rating.

Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:

Abo für kostenpflichtige Inhalte

Literatur
1.
Zurück zum Zitat Schiff D, Wen P, editors. Cancer neurology in clinical practice. Totowa, NJ: Humana Press Inc; 2003. Schiff D, Wen P, editors. Cancer neurology in clinical practice. Totowa, NJ: Humana Press Inc; 2003.
2.
Zurück zum Zitat Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. N Engl J Med. 2005;352(10):987–96. CrossRef Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. N Engl J Med. 2005;352(10):987–96. CrossRef
3.
Zurück zum Zitat Eisele SC, Wen PY, Lee EQ. Assessment of brain tumor response: RANO and its offspring. Curr Treat Options Oncol. 2016;17(7):35. CrossRef Eisele SC, Wen PY, Lee EQ. Assessment of brain tumor response: RANO and its offspring. Curr Treat Options Oncol. 2016;17(7):35. CrossRef
4.
Zurück zum Zitat Rees JH. Diagnosis and treatment in neuro-oncology: an oncological perspective. Br J Radiol. 2011;84(2):82–9. CrossRef Rees JH. Diagnosis and treatment in neuro-oncology: an oncological perspective. Br J Radiol. 2011;84(2):82–9. CrossRef
5.
Zurück zum Zitat Dhermain FG, Hau P, Lanfermann H, Jacobs AH, van den Bent MJ. Advanced MRI and PET imaging for assessment of treatment response in patients with gliomas. Lancet Neurol. 2010;9(9):906–20. CrossRef Dhermain FG, Hau P, Lanfermann H, Jacobs AH, van den Bent MJ. Advanced MRI and PET imaging for assessment of treatment response in patients with gliomas. Lancet Neurol. 2010;9(9):906–20. CrossRef
6.
Zurück zum Zitat Huang RY, Neagu MR, Reardon DA, Wen PY. Pitfalls in the neuroimaging of glioblastoma in the era of antiangiogenic and immuno/targeted therapy—detecting illusive disease, defining response. Front Neurol. 2015;23:6–33. Huang RY, Neagu MR, Reardon DA, Wen PY. Pitfalls in the neuroimaging of glioblastoma in the era of antiangiogenic and immuno/targeted therapy—detecting illusive disease, defining response. Front Neurol. 2015;23:6–33.
7.
Zurück zum Zitat Galldiks N, Stoffels G, Filss C, et al. The use of dynamic O‑(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma. Neuro Oncol. 2015;17(9):1293–3007. PubMedPubMedCentral Galldiks N, Stoffels G, Filss C, et al. The use of dynamic O‑(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma. Neuro Oncol. 2015;17(9):1293–3007. PubMedPubMedCentral
8.
Zurück zum Zitat Götz I, Grosu AL. [(18)F]FET-PET imaging for treatment and response monitoring of radiation therapy in malignant Glioma patients—A review. Front Oncol. 2013;25(3):104. Götz I, Grosu AL. [(18)F]FET-PET imaging for treatment and response monitoring of radiation therapy in malignant Glioma patients—A review. Front Oncol. 2013;25(3):104.
9.
Zurück zum Zitat Wefel JS, Cloughesy T, Zazzali JL, et al. Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol. 2011;13(6):660–8. CrossRef Wefel JS, Cloughesy T, Zazzali JL, et al. Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol. 2011;13(6):660–8. CrossRef
10.
Zurück zum Zitat Johnson DR, Sawyer AM, Meyers CA, O’Neill BP, Wefel JS. Early measures of cognitive function predict survival in patients with newly diagnosed glioblastoma. Neuro Oncol. 2012;14(6):808–16. CrossRef Johnson DR, Sawyer AM, Meyers CA, O’Neill BP, Wefel JS. Early measures of cognitive function predict survival in patients with newly diagnosed glioblastoma. Neuro Oncol. 2012;14(6):808–16. CrossRef
11.
Zurück zum Zitat Hilverda K, Bosma I, Heimans JJ, et al. Cognitive functioning in glioblastoma patients during radiotherapy and temozolomide treatment: initial findings. J Neurooncol. 2010;97(1):89–94. CrossRef Hilverda K, Bosma I, Heimans JJ, et al. Cognitive functioning in glioblastoma patients during radiotherapy and temozolomide treatment: initial findings. J Neurooncol. 2010;97(1):89–94. CrossRef
12.
Zurück zum Zitat Meyers CA, Hess KR. Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro Oncol. 2003;5(2):89–95. CrossRef Meyers CA, Hess KR. Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro Oncol. 2003;5(2):89–95. CrossRef
13.
Zurück zum Zitat Meyers CA, Hess KR, Yung WK, Levin VA. Cognitive function as a predictor of survival in patients with recurrent malignant glioma. J Clin Oncol. 2000;18(3):646–50. CrossRef Meyers CA, Hess KR, Yung WK, Levin VA. Cognitive function as a predictor of survival in patients with recurrent malignant glioma. J Clin Oncol. 2000;18(3):646–50. CrossRef
14.
Zurück zum Zitat Fliessbach K, Hoppe C, Schlegel U, Elger CE, Helmstaedter C. NeuroCogFX—a computer-based neuropsychological assessment battery for the follow-up examination of neurological patients. Fortschr Neurol Psychiatr. 2006;74(11):643–50. CrossRef Fliessbach K, Hoppe C, Schlegel U, Elger CE, Helmstaedter C. NeuroCogFX—a computer-based neuropsychological assessment battery for the follow-up examination of neurological patients. Fortschr Neurol Psychiatr. 2006;74(11):643–50. CrossRef
15.
Zurück zum Zitat Fliessbach K, Rogowski S, Hoppe C, et al. Computer-based assessment of cognitive functions in brain tumor patients. J Neurooncol. 2010;100(3):427–37. CrossRef Fliessbach K, Rogowski S, Hoppe C, et al. Computer-based assessment of cognitive functions in brain tumor patients. J Neurooncol. 2010;100(3):427–37. CrossRef
16.
Zurück zum Zitat Bodensohn R, Corradini S, Ganswindt U, et al. A prospective study on neurocognitive effects after primary radiotherapy in high-grade glioma patients. Int J Clin Oncol. 2016;21(4):642–50. CrossRef Bodensohn R, Corradini S, Ganswindt U, et al. A prospective study on neurocognitive effects after primary radiotherapy in high-grade glioma patients. Int J Clin Oncol. 2016;21(4):642–50. CrossRef
17.
Zurück zum Zitat Lehfeld H, Erzigkeit H. The SKT—a short cognitive performance test for assessing deficits of memory and attention. Int Psychogeriatr. 1997;9(l):115–21. CrossRef Lehfeld H, Erzigkeit H. The SKT—a short cognitive performance test for assessing deficits of memory and attention. Int Psychogeriatr. 1997;9(l):115–21. CrossRef
18.
Zurück zum Zitat Koch HJ, Gürtler K, Szecsey A. Correlation of mini-mental-state-examination (MMSE), Syndrom-Kurztest (SKT) and clock test (CT) scores in patients with cognitive impairment assessed by means of multiple regression and response surface analysis. Arch Gerontol Geriatr. 2005;40(1):7–14. CrossRef Koch HJ, Gürtler K, Szecsey A. Correlation of mini-mental-state-examination (MMSE), Syndrom-Kurztest (SKT) and clock test (CT) scores in patients with cognitive impairment assessed by means of multiple regression and response surface analysis. Arch Gerontol Geriatr. 2005;40(1):7–14. CrossRef
19.
Zurück zum Zitat Hoppe C, Fliessbach K, Schlegel U, Elger CE, Helmstaedter C, Hoppe C, et al. NeuroCog FX: computerized screening of cognitive functions in patients with epilepsy. Epilepsy Behav. 2009;16(2):298–310. CrossRef Hoppe C, Fliessbach K, Schlegel U, Elger CE, Helmstaedter C, Hoppe C, et al. NeuroCog FX: computerized screening of cognitive functions in patients with epilepsy. Epilepsy Behav. 2009;16(2):298–310. CrossRef
20.
Zurück zum Zitat Wen PY, Macdonald DR, Reardon DA, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963–72. CrossRef Wen PY, Macdonald DR, Reardon DA, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963–72. CrossRef
21.
Zurück zum Zitat Strauss SB, Meng A, Ebani EJ, Chiang GC. Imaging glioblastoma posttreatment: progression, pseudoprogression, pseudoresponse, radiation necrosis. Radiol Clin North Am. 2019;57(6):1199–216. CrossRef Strauss SB, Meng A, Ebani EJ, Chiang GC. Imaging glioblastoma posttreatment: progression, pseudoprogression, pseudoresponse, radiation necrosis. Radiol Clin North Am. 2019;57(6):1199–216. CrossRef
22.
Zurück zum Zitat Shiroishi MS, Boxerman JL, Pope WB. Physiologic MRI for assessment of response to therapy and prognosis in glioblastoma. Neuro Oncol. 2016;18(4):467–78. CrossRef Shiroishi MS, Boxerman JL, Pope WB. Physiologic MRI for assessment of response to therapy and prognosis in glioblastoma. Neuro Oncol. 2016;18(4):467–78. CrossRef
23.
Zurück zum Zitat Delgado-López PD, Riñones-Mena E, Corrales-García EM. Treatment-related changes in glioblastoma: a review on the controversies in response assessment criteria and the concepts of true progression, pseudoprogression, pseudoresponse and radionecrosis. Clin Transl Oncol. 2018;20(8):939–53. CrossRef Delgado-López PD, Riñones-Mena E, Corrales-García EM. Treatment-related changes in glioblastoma: a review on the controversies in response assessment criteria and the concepts of true progression, pseudoprogression, pseudoresponse and radionecrosis. Clin Transl Oncol. 2018;20(8):939–53. CrossRef
24.
Zurück zum Zitat Reardon DA, Ballman KV, Buckner JC, Chang SM, Ellingson BM. Impact of imaging measurements on response assessment in glioblastoma clinical trials. Neuro Oncol. 2014;16(7):24–35. CrossRef Reardon DA, Ballman KV, Buckner JC, Chang SM, Ellingson BM. Impact of imaging measurements on response assessment in glioblastoma clinical trials. Neuro Oncol. 2014;16(7):24–35. CrossRef
25.
Zurück zum Zitat Reithmeier T, Lopez WO, Doostkam S, et al. Intraindividual comparison of histopathological diagnosis obtained by stereotactic serial biopsy to open surgical resection specimen in patients with intracranial tumours. Clin Neurol Neurosurg. 2013;115(10):1955–60. CrossRef Reithmeier T, Lopez WO, Doostkam S, et al. Intraindividual comparison of histopathological diagnosis obtained by stereotactic serial biopsy to open surgical resection specimen in patients with intracranial tumours. Clin Neurol Neurosurg. 2013;115(10):1955–60. CrossRef
26.
Zurück zum Zitat Tilgner J, Herr M, Ostertag C, Volk B. Validation of intraoperative diagnoses using smear preparations from stereotactic brain biopsies: intraoperativeversus final diagnosis—influence of clinical factors. Neurosurgery. 2005;56(2):257–65. CrossRef Tilgner J, Herr M, Ostertag C, Volk B. Validation of intraoperative diagnoses using smear preparations from stereotactic brain biopsies: intraoperativeversus final diagnosis—influence of clinical factors. Neurosurgery. 2005;56(2):257–65. CrossRef
27.
Zurück zum Zitat Pillay B, Wootten AC, Crowe H, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature. Cancer Treat Rev. 2016;42:56–72. CrossRef Pillay B, Wootten AC, Crowe H, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature. Cancer Treat Rev. 2016;42:56–72. CrossRef
28.
Zurück zum Zitat Taylor C, Munro AJ, Glynne-Jones R, Griffith C, Trevatt P, Richards M, et al. Multidisciplinary team working in cancer: what is the evidence? BMJ. 2010;23(340):c951. CrossRef Taylor C, Munro AJ, Glynne-Jones R, Griffith C, Trevatt P, Richards M, et al. Multidisciplinary team working in cancer: what is the evidence? BMJ. 2010;23(340):c951. CrossRef
29.
Zurück zum Zitat Ellingson BM, Wen PY, Cloughesy TF. Modified criteria for radiographic response assessment in glioblastoma. Clin Trials Neurother. 2017;14(2):307–20. Ellingson BM, Wen PY, Cloughesy TF. Modified criteria for radiographic response assessment in glioblastoma. Clin Trials Neurother. 2017;14(2):307–20.
30.
Zurück zum Zitat Wen PY, Chang SM, Van den Bent MJ, Vogelbaum MA, Macdonald DR, Eudocia QL. Response assessment in neuro-oncology clinical trials. J Clin Oncol. 2017;35(21):2439–49. CrossRef Wen PY, Chang SM, Van den Bent MJ, Vogelbaum MA, Macdonald DR, Eudocia QL. Response assessment in neuro-oncology clinical trials. J Clin Oncol. 2017;35(21):2439–49. CrossRef
31.
Zurück zum Zitat Lincoln CM, Fata P, Sotardi S, Pohlen M, Uribe T, Bello JA. Imaging spectrum of immunomodulating, chemotherapeutic and radiation therapy-related intracranial effects. Br J Radiol. 2018;91(1082):553–64. Lincoln CM, Fata P, Sotardi S, Pohlen M, Uribe T, Bello JA. Imaging spectrum of immunomodulating, chemotherapeutic and radiation therapy-related intracranial effects. Br J Radiol. 2018;91(1082):553–64.
32.
Zurück zum Zitat Kim HS, Goh MJ, Kim N, Choi CG, Kim SJ, Kim JH. Which combination of MR imaging modalities is best for predicting recurrent glioblastoma? Study of diagnostic accuracy and reproducibility. Radiology. 2014;273(3):831–43. CrossRef Kim HS, Goh MJ, Kim N, Choi CG, Kim SJ, Kim JH. Which combination of MR imaging modalities is best for predicting recurrent glioblastoma? Study of diagnostic accuracy and reproducibility. Radiology. 2014;273(3):831–43. CrossRef
Metadaten
Titel
Multimodal assessment of disease activity in glioblastoma
A single center experience
verfasst von
Alexander Tinchon
Franz Marhold
Bernadette Calabek-Wohinz
Katharina Hainz
Martina Tesar-Pelz
Gregory Minear
Elisabeth Freydl
Katrin Blauensteiner
Gertraud Heinz
MD, Prof, FEAN Stefan Oberndorfer
Publikationsdatum
20.04.2021
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 21-22/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-021-01859-2