A Novel Approach to Determining Tumor Progression Using a Three-Site Pilot Clinical Trial of Spectroscopic MRI-Guided Radiation Dose Escalation in Glioblastoma
| Title: | A Novel Approach to Determining Tumor Progression Using a Three-Site Pilot Clinical Trial of Spectroscopic MRI-Guided Radiation Dose Escalation in Glioblastoma |
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| Authors: | Karthik K. Ramesh, Vicki Huang, Jeffrey Rosenthal, Eric A. Mellon, Mohammed Goryawala, Peter B. Barker, Saumya S. Gurbani, Anuradha G. Trivedi, Alexander S. Giuffrida, Eduard Schreibmann, Hui Han, Macarena de le Fuente, Erin M. Dunbar, Matthias Holdhoff, Lawrence R. Kleinberg, Hui-Kuo G. Shu, Hyunsuk Shim, Brent D. Weinberg |
| Source: | Tomography, Vol 9, Iss 1, Pp 362-374 (2023) |
| Publisher Information: | MDPI AG, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Computer applications to medicine. Medical informatics |
| Subject Terms: | glioblastoma, GBM, spectroscopy, spectroscopic MRI, MRSI, radiation dose-escalation, Computer applications to medicine. Medical informatics, R858-859.7 |
| More Details: | Glioblastoma (GBM) is a fatal disease, with poor prognosis exacerbated by difficulty in assessing tumor extent with imaging. Spectroscopic MRI (sMRI) is a non-contrast imaging technique measuring endogenous metabolite levels of the brain that can serve as biomarkers for tumor extension. We completed a three-site study to assess survival benefits of GBM patients when treated with escalated radiation dose guided by metabolic abnormalities in sMRI. Escalated radiation led to complex post-treatment imaging, requiring unique approaches to discern tumor progression from radiation-related treatment effect through our quantitative imaging platform. The purpose of this study is to determine true tumor recurrence timepoints for patients in our dose-escalation multisite study using novel methodology and to report on median progression-free survival (PFS). Follow-up imaging for all 30 trial patients were collected, lesion volumes segmented and graphed, and imaging uploaded to our platform for visual interpretation. Eighteen months post-enrollment, the median PFS was 16.6 months with a median time to follow-up of 20.3 months. With this new treatment paradigm, incidence rate of tumor recurrence one year from treatment is 30% compared to 60–70% failure under standard care. Based on the delayed tumor progression and improved survival, a randomized phase II trial is under development (EAF211). |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2379-139X 2379-1381 |
| Relation: | https://www.mdpi.com/2379-139X/9/1/29; https://doaj.org/toc/2379-1381; https://doaj.org/toc/2379-139X |
| DOI: | 10.3390/tomography9010029 |
| Access URL: | https://doaj.org/article/7e1bf384b7a148daa2140d6801c84cdc |
| Accession Number: | edsdoj.7e1bf384b7a148daa2140d6801c84cdc |
| Database: | Directory of Open Access Journals |
| ISSN: | 2379139X 23791381 |
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| DOI: | 10.3390/tomography9010029 |
| Published in: | Tomography |
| Language: | English |