Differentiation of recurrent glioblastoma multiforme from radiation necrosis after external beam radiation therapy with dynamic susceptibility- weighted contrast-enhanced perfusion MR imaging

Ramon Barajas, Jamie S. Chang, Mark R. Segal, Andrew T. Parsa, Michael W. McDermott, Mitchel S. Berger, Soonmee Cha

Research output: Contribution to journalArticle

232 Citations (Scopus)

Abstract

Purpose: To investigate whether cerebral blood volume (CBV), peak height (PH), and percentage of signal intensity recovery (PSR) measurements derived from the results of T2*-weighted dynamic susceptibility-weighted contrast material-enhanced (DSC) magnetic resonance (MR) imaging performed after external beam radiation therapy (EBRT) can be used to distinguish recurrent glioblastoma multiforme (GBM) from radiation necrosis. Materials and Methods: Fifty-seven patients were enrolled in this HIPAA-compliant institutional review board-approved retrospective study after they received a diagnosis of GBM, underwent EBRT, and were examined with DSC MR imaging, which revealed progressive contrast enhancement within the radiation field. A definitive diagnosis was established at subsequent surgical resection or clinicoradiologic follow-up. Regions of interest were retrospectively drawn around the entire contrast-enhanced region. This created T2*-weighted signal intensity-time curves that produced three cerebral hemodynamic MR imaging measurements: CBV, PH, and PSR. Welch t tests were used to compare measurements between groups. Results: Mean, maximum, and minimum relative PH and relative CBV were significantly higher (P <.01) in patients with recurrent GBM than in patients with radiation necrosis. Mean, maximum, and minimum relative PSR values were significantly lower (P <.05) in patients with recurrent GBM than in patients with radiation necrosis. Conclusion: These findings suggest that DSC perfusion MR imaging may be used to differentiate recurrent GBM from EBRT-induced radiation necrosis.

Original languageEnglish (US)
Pages (from-to)486-496
Number of pages11
JournalRadiology
Volume253
Issue number2
DOIs
StatePublished - Nov 2009
Externally publishedYes

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Magnetic Resonance Angiography
Glioblastoma
Necrosis
Radiotherapy
Radiation
Magnetic Resonance Imaging
Health Insurance Portability and Accountability Act
Research Ethics Committees
Contrast Media
Retrospective Studies
Hemodynamics
Cerebral Blood Volume

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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Differentiation of recurrent glioblastoma multiforme from radiation necrosis after external beam radiation therapy with dynamic susceptibility- weighted contrast-enhanced perfusion MR imaging. / Barajas, Ramon; Chang, Jamie S.; Segal, Mark R.; Parsa, Andrew T.; McDermott, Michael W.; Berger, Mitchel S.; Cha, Soonmee.

In: Radiology, Vol. 253, No. 2, 11.2009, p. 486-496.

Research output: Contribution to journalArticle

Barajas, Ramon ; Chang, Jamie S. ; Segal, Mark R. ; Parsa, Andrew T. ; McDermott, Michael W. ; Berger, Mitchel S. ; Cha, Soonmee. / Differentiation of recurrent glioblastoma multiforme from radiation necrosis after external beam radiation therapy with dynamic susceptibility- weighted contrast-enhanced perfusion MR imaging. In: Radiology. 2009 ; Vol. 253, No. 2. pp. 486-496.
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