van Dijken, Bart R.J.; van Laar, Peter Jan; Smits, Marion; Dankbaar, Jan Willem; Enting, Roelien H.; van der Hoorn, Anouk
(2019) Journal of Magnetic Resonance Imaging, volume 49, issue 1, pp. 11 - 22
Treatment evaluation of patients with glioblastomas is important to aid in clinical decisions. Conventional MRI with contrast is currently the standard method, but unable to differentiate tumor progression from treatment-related effects. Pseudoprogression appears as new enhancement, and thus mimics tumor progression on conventional MRI. Contrarily, a decrease in enhancement or ... read more edema on conventional MRI during antiangiogenic treatment can be due to pseudoresponse and is not necessarily reflective of a favorable outcome. Neovascularization is a hallmark of tumor progression but not for posttherapeutic effects. Perfusion-weighted MRI provides a plethora of additional parameters that can help to identify this neovascularization. This review shows that perfusion MRI aids to identify tumor progression, pseudoprogression, and pseudoresponse. The review provides an overview of the most applicable perfusion MRI methods and their limitations. Finally, future developments and remaining challenges of perfusion MRI in treatment evaluation in neuro-oncology are discussed. Level of Evidence: 3. Technical Efficacy: Stage 4. J. Magn. Reson. Imaging 2019;49:11–22. show less
Keywords: glioblastoma, magnetic resonance imaging, perfusion imaging, treatment evaluation, Reproducibility of Results, Brain Neoplasms/diagnostic imaging, Contrast Media/pharmacology, Humans, Magnetic Resonance Angiography/methods, Disease Progression, Edema/diagnostic imaging, Glioblastoma/diagnostic imaging, Brain/diagnostic imaging, Neuroimaging/methods, Image Processing, Computer-Assisted/methods, Radiology Nuclear Medicine and imaging, Review, Research Support, Non-U.S. Gov't, Journal Article
Note: © 2018 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.