Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 13015
© 2008 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Abdel Wahab, M. M. Articles by Osman, M. A. Search for Related Content PubMed Articles by Abdel Wahab, M. M. Articles by Osman, M. A.

Abstract

The prognostic value of radiological bio-markers for detection of cerebral glioma grades and early evaluation of tumor response to radiation therapy using MRI perfusion and spectroscopy

Faculty of Medicine, Ain Shams University, Heliopolis Cairo, Egypt

13015

Background: The early and accurate prediction of treatment response in brain gliomas after radiation therapy using MRI perfusion and spectroscopy may provide an opportunity to switch to more beneficial to none responders instead of the limited delayed structural data obtained via the use of conventional MRI. Our aim was to analyze these recent modalities to evaluate the combined application on the treatment plan. Methods: Forty-six patients with brain astrocytomas were recruited in this study, they were examined prospectively before and after radiation therapy at regular intervals over a period of two years, using conventional MRI, MRI perfusion and spectroscopy. The findings were correlated the histopathological grade of the tumor and different tumor response to treatment for each individual patient. Those patients with early poor response or resistant to radiation, chemotherapy was added in the form of Temozolamide 175mg/m² for 5 days every consecutive 28 days, meanwhile patients with good response, no further treatment was added with regular follow-up. Results: Initial base line radiological studies before radiotherapy were correlated with the histopathological grade. Both MRI spectroscopy and biomarkers Choline/Creatinine, Choline/NAA were statistically significant (0.001,0.004) respectively to differentiate between high grade (III,IV) and low grade (II). As well as MRI perfusion with P. value 0.042, meanwhile conventional MRI data was not statistically significant except for necrosis and edema. (P=0.002). For the assessment of the early response after 4 weeks of completion of radiotherapy, Conventional MRI was only significant as regard the enhancement (P=0.0001) Biomarkers of spectroscopy were highly significant for Choline/Creatinine, NAA/Creatinine and Choline/NAA, with P values (0.005,0.025,0.01) respectively. MRI perfusion was also statistically significant with P value 0.004. Conclusions: Both MRI perfusion and spectroscopy are important and promising new modalities for diagnosis and early therapeutic evaluation of brain tumor response after radiation therapy for proper selection of patients in need of further chemotherapeutic treatment.

No significant financial relationships to disclose.