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Dynamic Contrast-Enhanced Magnetic Resonance Imaging May Act as a Biomarker for Vascular Damage in Normal Appearing Brain Tissue after Radiotherapy in Patients with Glioblastoma
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
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(English)Manuscript (preprint) (Other academic)
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-346813OAI: oai:DiVA.org:uu-346813DiVA, id: diva2:1192184
Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2018-04-03
In thesis
1. Perfusion MRI of the brain after radiotherapy in patients with glioblastoma – potential and problems
Open this publication in new window or tab >>Perfusion MRI of the brain after radiotherapy in patients with glioblastoma – potential and problems
2018 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Perfusion Magnetic Resonance Imaging (MRI) is a useful tool in diagnostic evaluation and treatment response assessment in patients with glioblastoma. The standard treatment regimen includes surgical resection, radiotherapy and adjuvant chemotherapy. However, prognosis is poor; relative 5-year survival is 3–5%. Radiotherapy sequelae may have considerable negative effects on the patients’ quality of life. Acute and early delayed radiation-induced injury is primarily considered damage to the cerebral vascular tissue.

 

The general aim of this study was to evaluate how perfusion MRI evaluation, based on contrast agent administration (DSC- and DCE-MRI), is affected by or can be useful to assess radiation-induced changes in normal appearing brain tissue in patients with glioblastoma after radiotherapy.

 

Paper I: Dynamic Susceptibility Contrast (DSC)-MRI is a common perfusion MRI method in clinical practice in patients with glioblastoma. Due to inherent limitations, cerebral blood volume (CBV) and cerebral blood flow (CBF) derived from DSC-MRI are normalized to contralateral normal appearing white matter. Ten patients with glioblastoma were examined. Regional and global normalized CBV and normalized CBF in white and gray matter decreased after radiotherapy, followed by a tendency to recover. The response of nCBV and nCBF was dose-dependent in white matter but not in gray matter. In conclusion, radiotherapy effects on normal appearing white matter can confound treatment evaluation with DSC-MRI in patients with glioblastoma.

 

Paper II: Dynamic Contrast Enhanced (DCE)-MRI may be useful in evaluating radiation-induced damage in normal appearing brain tissue.  DCE-MRI-derived parameters, vascular permeability (Ktrans) and the fractional volume of the extravascular extracellular space (Ve) are potential biomarkers. Twelve patients with glioblastoma were examined. A tendency toward increased Ktrans and Ve was seen, suggesting that these parameters may act as potential biomarkers for acute and early delayed radiation-induced vascular damage

Place, publisher, year, edition, pages
Uppsala: Uppsala universitet, 2018
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-346814 (URN)
Presentation
2018-04-13, Akademiska Sjukhuset, Uppsala, 12:00 (Swedish)
Supervisors
Available from: 2018-04-04 Created: 2018-04-03 Last updated: 2018-04-04Bibliographically approved

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