Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion

Jayant Narang; Rajan Jain; Ali Syed Arbab; Tom Mikkelsen; Lisa Scarpace; Mark L. Rosenblum; David Hearshen; Abbas Babajani-Feremi

doi:10.1093/neuonc/nor075

Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion

Jayant Narang, Rajan Jain, Ali Syed Arbab, Tom Mikkelsen, Lisa Scarpace, Mark L. Rosenblum, David Hearshen, Abbas Babajani-Feremi

Research output: Contribution to journal › Article › peer-review

98 Scopus citations

Abstract

Differentiating treatment-induced necrosis (TIN) from recurrent/progressive tumor (RPT) in brain tumor patients using conventional morphologic imaging features is a very challenging task. Functional imaging techniques also offer moderate success due to the complexity of the tissue microenvironment and the inherent limitation of the various modalities and techniques. The purpose of this retrospective study was to assess the utility of nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion (DCET1MRP) in differentiating TIN from RPT. Twenty-nine patients with previously treated brain tumors who showed recurrent or progressive enhancing lesion on follow-up MRI underwent DCET1MRP. Another 8 patients with treatment-naïve high-grade gliomas who also underwent DCET1MRP were included as the control group. Semiquantitative indices derived from DCET1MRP included maximum slope of enhancement in initial vascular phase (MSIVP), normalized MSIVP (nMSIVP), normalized slope of delayed equilibrium phase (nSDEP), and initial area under the time-intensity curve (IAUC) at 60 and 120 s (IAUC ₆₀ and IAUC ₁₂₀) obtained from the enhancement curve. There was a statistically significant difference between the 2 groups (P < .01), with the RPT group showing higher MSIVP (15.78 vs 8.06), nMSIVP (0.046 vs 0.028), nIAUC60 (33.07 vs 6.44), and nIAUC120 (80.14 vs 65.55) compared with the TIN group. nSDEP was significantly lower in the RPT group (7.20 × 10 ^-5 vs 15.35 × 10 ^-5) compared with the TIN group. Analysis of the receiver-operatingcharacteristic curve showed nMSIVP to be the best single predictor of RPT, with very high (95%) sensitivity and high (78%) specificity. Thus, nonmodel-based semiquantitative indices derived from DCET1MRP that are relatively easy to derive and do not require a complex model-based approach may aid in differentiating RPT from TIN and can be used as robust noninvasive imaging biomarkers.

Original language	English (US)
Pages (from-to)	1037-1046
Number of pages	10
Journal	Neuro-Oncology
Volume	13
Issue number	9
DOIs	https://doi.org/10.1093/neuonc/nor075
State	Published - Sep 2011
Externally published	Yes

Keywords

DCE-MRI
MR perfusion
Recurrent tumor
Semiquantitative indices
Treatment-induced necrosis

ASJC Scopus subject areas

Oncology
Clinical Neurology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/neuonc/nor075

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Narang, J., Jain, R., Arbab, A. S., Mikkelsen, T., Scarpace, L., Rosenblum, M. L., Hearshen, D., & Babajani-Feremi, A. (2011). Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion. Neuro-Oncology, 13(9), 1037-1046. https://doi.org/10.1093/neuonc/nor075

Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion. / Narang, Jayant; Jain, Rajan; Arbab, Ali Syed et al.
In: Neuro-Oncology, Vol. 13, No. 9, 09.2011, p. 1037-1046.

Research output: Contribution to journal › Article › peer-review

Narang, J, Jain, R, Arbab, AS, Mikkelsen, T, Scarpace, L, Rosenblum, ML, Hearshen, D & Babajani-Feremi, A 2011, 'Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion', Neuro-Oncology, vol. 13, no. 9, pp. 1037-1046. https://doi.org/10.1093/neuonc/nor075

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title = "Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion",

abstract = "Differentiating treatment-induced necrosis (TIN) from recurrent/progressive tumor (RPT) in brain tumor patients using conventional morphologic imaging features is a very challenging task. Functional imaging techniques also offer moderate success due to the complexity of the tissue microenvironment and the inherent limitation of the various modalities and techniques. The purpose of this retrospective study was to assess the utility of nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion (DCET1MRP) in differentiating TIN from RPT. Twenty-nine patients with previously treated brain tumors who showed recurrent or progressive enhancing lesion on follow-up MRI underwent DCET1MRP. Another 8 patients with treatment-na{\"i}ve high-grade gliomas who also underwent DCET1MRP were included as the control group. Semiquantitative indices derived from DCET1MRP included maximum slope of enhancement in initial vascular phase (MSIVP), normalized MSIVP (nMSIVP), normalized slope of delayed equilibrium phase (nSDEP), and initial area under the time-intensity curve (IAUC) at 60 and 120 s (IAUC 60 and IAUC 120) obtained from the enhancement curve. There was a statistically significant difference between the 2 groups (P < .01), with the RPT group showing higher MSIVP (15.78 vs 8.06), nMSIVP (0.046 vs 0.028), nIAUC60 (33.07 vs 6.44), and nIAUC120 (80.14 vs 65.55) compared with the TIN group. nSDEP was significantly lower in the RPT group (7.20 × 10 -5 vs 15.35 × 10 -5) compared with the TIN group. Analysis of the receiver-operatingcharacteristic curve showed nMSIVP to be the best single predictor of RPT, with very high (95%) sensitivity and high (78%) specificity. Thus, nonmodel-based semiquantitative indices derived from DCET1MRP that are relatively easy to derive and do not require a complex model-based approach may aid in differentiating RPT from TIN and can be used as robust noninvasive imaging biomarkers.",

keywords = "DCE-MRI, MR perfusion, Recurrent tumor, Semiquantitative indices, Treatment-induced necrosis",

author = "Jayant Narang and Rajan Jain and Arbab, {Ali Syed} and Tom Mikkelsen and Lisa Scarpace and Rosenblum, {Mark L.} and David Hearshen and Abbas Babajani-Feremi",

year = "2011",

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AU - Jain, Rajan

AU - Arbab, Ali Syed

AU - Mikkelsen, Tom

AU - Scarpace, Lisa

AU - Rosenblum, Mark L.

AU - Hearshen, David

AU - Babajani-Feremi, Abbas

PY - 2011/9

Y1 - 2011/9

N2 - Differentiating treatment-induced necrosis (TIN) from recurrent/progressive tumor (RPT) in brain tumor patients using conventional morphologic imaging features is a very challenging task. Functional imaging techniques also offer moderate success due to the complexity of the tissue microenvironment and the inherent limitation of the various modalities and techniques. The purpose of this retrospective study was to assess the utility of nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion (DCET1MRP) in differentiating TIN from RPT. Twenty-nine patients with previously treated brain tumors who showed recurrent or progressive enhancing lesion on follow-up MRI underwent DCET1MRP. Another 8 patients with treatment-naïve high-grade gliomas who also underwent DCET1MRP were included as the control group. Semiquantitative indices derived from DCET1MRP included maximum slope of enhancement in initial vascular phase (MSIVP), normalized MSIVP (nMSIVP), normalized slope of delayed equilibrium phase (nSDEP), and initial area under the time-intensity curve (IAUC) at 60 and 120 s (IAUC 60 and IAUC 120) obtained from the enhancement curve. There was a statistically significant difference between the 2 groups (P < .01), with the RPT group showing higher MSIVP (15.78 vs 8.06), nMSIVP (0.046 vs 0.028), nIAUC60 (33.07 vs 6.44), and nIAUC120 (80.14 vs 65.55) compared with the TIN group. nSDEP was significantly lower in the RPT group (7.20 × 10 -5 vs 15.35 × 10 -5) compared with the TIN group. Analysis of the receiver-operatingcharacteristic curve showed nMSIVP to be the best single predictor of RPT, with very high (95%) sensitivity and high (78%) specificity. Thus, nonmodel-based semiquantitative indices derived from DCET1MRP that are relatively easy to derive and do not require a complex model-based approach may aid in differentiating RPT from TIN and can be used as robust noninvasive imaging biomarkers.

AB - Differentiating treatment-induced necrosis (TIN) from recurrent/progressive tumor (RPT) in brain tumor patients using conventional morphologic imaging features is a very challenging task. Functional imaging techniques also offer moderate success due to the complexity of the tissue microenvironment and the inherent limitation of the various modalities and techniques. The purpose of this retrospective study was to assess the utility of nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion (DCET1MRP) in differentiating TIN from RPT. Twenty-nine patients with previously treated brain tumors who showed recurrent or progressive enhancing lesion on follow-up MRI underwent DCET1MRP. Another 8 patients with treatment-naïve high-grade gliomas who also underwent DCET1MRP were included as the control group. Semiquantitative indices derived from DCET1MRP included maximum slope of enhancement in initial vascular phase (MSIVP), normalized MSIVP (nMSIVP), normalized slope of delayed equilibrium phase (nSDEP), and initial area under the time-intensity curve (IAUC) at 60 and 120 s (IAUC 60 and IAUC 120) obtained from the enhancement curve. There was a statistically significant difference between the 2 groups (P < .01), with the RPT group showing higher MSIVP (15.78 vs 8.06), nMSIVP (0.046 vs 0.028), nIAUC60 (33.07 vs 6.44), and nIAUC120 (80.14 vs 65.55) compared with the TIN group. nSDEP was significantly lower in the RPT group (7.20 × 10 -5 vs 15.35 × 10 -5) compared with the TIN group. Analysis of the receiver-operatingcharacteristic curve showed nMSIVP to be the best single predictor of RPT, with very high (95%) sensitivity and high (78%) specificity. Thus, nonmodel-based semiquantitative indices derived from DCET1MRP that are relatively easy to derive and do not require a complex model-based approach may aid in differentiating RPT from TIN and can be used as robust noninvasive imaging biomarkers.

KW - DCE-MRI

KW - MR perfusion

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Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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