Does MR perfusion imaging impact management decisions for patients with brain tumors? A prospective study

C. P. Geer, J. Simonds, A. Anvery, M. Y. Chen, J. H. Burdette, M. E. Zapadka, T. L. Ellis, S. B. Tatter, G. J. Lesser, M. D. Chan, K. P. McMullen, Annette Johnson

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: MR perfusion imaging can be used to help predict glial tumor grade and disease progression. Our purpose was to evaluate whether perfusion imaging has a diagnostic or therapeutic impact on clinical management planning in patients with glioma. MATERIALS AND METHODS: Standard MR imaging protocols were interpreted by a group of 3 NRs in consensus, with each case being interpreted twice: first, including routine sequences; and second, with the addition of perfusion imaging. A multidisciplinary team of treating physicians assessed tumor status and created hypothetical management plans, on the basis of clinical presentation and routine MR imaging and then routine MR imaging plus perfusion MR imaging. Physicians' confidence in the tumor status assessment and management plan was measured by using Likert-type items. RESULTS: Fifty-nine consecutive subjects with glial tumors were evaluated; 50 had known pathologic diagnoses. NRs and the treatment team agreed on tumor status in 45/50 cases (κ = 0.81). With the addition of perfusion, confidence in status assessment increased in 20 (40%) for NRs and in 28 (56%) for the treatment team. Of the 59 patient-care episodes, the addition of perfusion was associated with a change in management plan in 5 (8.5%) and an increase in the treatment team's confidence in their management plan in 34 (57.6%). NRs and the treatment team found perfusion useful in most episodes of care and wanted perfusion included in future MR images for >80% of these subjects. CONCLUSIONS: Perfusion imaging appears to have a significant impact on clinical decision-making and subspecialist physicians' confidence in management plans for patients with brain tumor.

Original languageEnglish (US)
Pages (from-to)556-562
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume33
Issue number3
DOIs
StatePublished - Mar 1 2012

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Perfusion Imaging
Brain Neoplasms
Prospective Studies
Perfusion
Episode of Care
Neoplasms
Physicians
Neuroglia
Therapeutics
Glioma
Disease Progression

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Does MR perfusion imaging impact management decisions for patients with brain tumors? A prospective study. / Geer, C. P.; Simonds, J.; Anvery, A.; Chen, M. Y.; Burdette, J. H.; Zapadka, M. E.; Ellis, T. L.; Tatter, S. B.; Lesser, G. J.; Chan, M. D.; McMullen, K. P.; Johnson, Annette.

In: American Journal of Neuroradiology, Vol. 33, No. 3, 01.03.2012, p. 556-562.

Research output: Contribution to journalArticle

Geer, CP, Simonds, J, Anvery, A, Chen, MY, Burdette, JH, Zapadka, ME, Ellis, TL, Tatter, SB, Lesser, GJ, Chan, MD, McMullen, KP & Johnson, A 2012, 'Does MR perfusion imaging impact management decisions for patients with brain tumors? A prospective study', American Journal of Neuroradiology, vol. 33, no. 3, pp. 556-562. https://doi.org/10.3174/ajnr.A2811
Geer, C. P. ; Simonds, J. ; Anvery, A. ; Chen, M. Y. ; Burdette, J. H. ; Zapadka, M. E. ; Ellis, T. L. ; Tatter, S. B. ; Lesser, G. J. ; Chan, M. D. ; McMullen, K. P. ; Johnson, Annette. / Does MR perfusion imaging impact management decisions for patients with brain tumors? A prospective study. In: American Journal of Neuroradiology. 2012 ; Vol. 33, No. 3. pp. 556-562.
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abstract = "BACKGROUND AND PURPOSE: MR perfusion imaging can be used to help predict glial tumor grade and disease progression. Our purpose was to evaluate whether perfusion imaging has a diagnostic or therapeutic impact on clinical management planning in patients with glioma. MATERIALS AND METHODS: Standard MR imaging protocols were interpreted by a group of 3 NRs in consensus, with each case being interpreted twice: first, including routine sequences; and second, with the addition of perfusion imaging. A multidisciplinary team of treating physicians assessed tumor status and created hypothetical management plans, on the basis of clinical presentation and routine MR imaging and then routine MR imaging plus perfusion MR imaging. Physicians' confidence in the tumor status assessment and management plan was measured by using Likert-type items. RESULTS: Fifty-nine consecutive subjects with glial tumors were evaluated; 50 had known pathologic diagnoses. NRs and the treatment team agreed on tumor status in 45/50 cases (κ = 0.81). With the addition of perfusion, confidence in status assessment increased in 20 (40{\%}) for NRs and in 28 (56{\%}) for the treatment team. Of the 59 patient-care episodes, the addition of perfusion was associated with a change in management plan in 5 (8.5{\%}) and an increase in the treatment team's confidence in their management plan in 34 (57.6{\%}). NRs and the treatment team found perfusion useful in most episodes of care and wanted perfusion included in future MR images for >80{\%} of these subjects. CONCLUSIONS: Perfusion imaging appears to have a significant impact on clinical decision-making and subspecialist physicians' confidence in management plans for patients with brain tumor.",
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AU - Burdette, J. H.

AU - Zapadka, M. E.

AU - Ellis, T. L.

AU - Tatter, S. B.

AU - Lesser, G. J.

AU - Chan, M. D.

AU - McMullen, K. P.

AU - Johnson, Annette

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N2 - BACKGROUND AND PURPOSE: MR perfusion imaging can be used to help predict glial tumor grade and disease progression. Our purpose was to evaluate whether perfusion imaging has a diagnostic or therapeutic impact on clinical management planning in patients with glioma. MATERIALS AND METHODS: Standard MR imaging protocols were interpreted by a group of 3 NRs in consensus, with each case being interpreted twice: first, including routine sequences; and second, with the addition of perfusion imaging. A multidisciplinary team of treating physicians assessed tumor status and created hypothetical management plans, on the basis of clinical presentation and routine MR imaging and then routine MR imaging plus perfusion MR imaging. Physicians' confidence in the tumor status assessment and management plan was measured by using Likert-type items. RESULTS: Fifty-nine consecutive subjects with glial tumors were evaluated; 50 had known pathologic diagnoses. NRs and the treatment team agreed on tumor status in 45/50 cases (κ = 0.81). With the addition of perfusion, confidence in status assessment increased in 20 (40%) for NRs and in 28 (56%) for the treatment team. Of the 59 patient-care episodes, the addition of perfusion was associated with a change in management plan in 5 (8.5%) and an increase in the treatment team's confidence in their management plan in 34 (57.6%). NRs and the treatment team found perfusion useful in most episodes of care and wanted perfusion included in future MR images for >80% of these subjects. CONCLUSIONS: Perfusion imaging appears to have a significant impact on clinical decision-making and subspecialist physicians' confidence in management plans for patients with brain tumor.

AB - BACKGROUND AND PURPOSE: MR perfusion imaging can be used to help predict glial tumor grade and disease progression. Our purpose was to evaluate whether perfusion imaging has a diagnostic or therapeutic impact on clinical management planning in patients with glioma. MATERIALS AND METHODS: Standard MR imaging protocols were interpreted by a group of 3 NRs in consensus, with each case being interpreted twice: first, including routine sequences; and second, with the addition of perfusion imaging. A multidisciplinary team of treating physicians assessed tumor status and created hypothetical management plans, on the basis of clinical presentation and routine MR imaging and then routine MR imaging plus perfusion MR imaging. Physicians' confidence in the tumor status assessment and management plan was measured by using Likert-type items. RESULTS: Fifty-nine consecutive subjects with glial tumors were evaluated; 50 had known pathologic diagnoses. NRs and the treatment team agreed on tumor status in 45/50 cases (κ = 0.81). With the addition of perfusion, confidence in status assessment increased in 20 (40%) for NRs and in 28 (56%) for the treatment team. Of the 59 patient-care episodes, the addition of perfusion was associated with a change in management plan in 5 (8.5%) and an increase in the treatment team's confidence in their management plan in 34 (57.6%). NRs and the treatment team found perfusion useful in most episodes of care and wanted perfusion included in future MR images for >80% of these subjects. CONCLUSIONS: Perfusion imaging appears to have a significant impact on clinical decision-making and subspecialist physicians' confidence in management plans for patients with brain tumor.

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