TY - JOUR
T1 - High-Grade Glioma Treatment Response Monitoring Biomarkers (1)
T2 - A Position Statement on the Evidence Supporting the Use of Advanced MRI Techniques in the Clinic, and the Latest Bench-to-Bedside Developments. Part 1: Perfusion and Diffusion Techniques
AU - Henriksen, Otto M.
AU - del Mar Álvarez-Torres, María
AU - Figueiredo, Patricia
AU - Hangel, Gilbert
AU - Keil, Vera C.
AU - Nechifor, Ruben E.
AU - Riemer, Frank
AU - Schmainda, Kathleen M.
AU - Warnert, Esther A.H.
AU - Wiegers, Evita C.
AU - Booth, Thomas C.
N1 - Funding Information:
This publication is part of the COST Action CA18206 Glioma MR Imaging 2.0 ( www.glimr.eu ), supported by COST (European Cooperation in Science and Technology), www.cost.eu . GliMR provided travel and accommodation for members who had travelled to early networking meetings. No participants were remunerated for their contribution. Funding support for KS: National Institute of Health/National Cancer Institute R01 CA255123, U01 CA176110, UG3 CA247606, Medical College of Wisconsin Cancer Center; GH: Austrian Science Fund grant KLI-646; ECW: The Dutch Research Council (NWO) Talent Programme Veni: 18144; EAHW: The Dutch Research Council (NWO) Talent Programme Veni: 91619121; PF: The Portuguese Foundation for Science and Technology (FCT) Grant UIDB/50009/2020; RN: Babes-Bolyai University, Grant GTC No. 35277/18.11.2020. TB was supported by the Wellcome/EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z]. MÁ-T was supported by the ALBATROSS project (National Plan for Scientific and Technical Research and Innovation 2017-2020 and DPI2016-80054-R (Programa Estatal de Promoción del Talento y su Empleabilidad en I+D+i).
Publisher Copyright:
Copyright © 2022 Henriksen, del Mar Álvarez-Torres, Figueiredo, Hangel, Keil, Nechifor, Riemer, Schmainda, Warnert, Wiegers and Booth.
Copyright © 2022 Henriksen, del Mar Álvarez-Torres, Figueiredo, Hangel, Keil, Nechifor, Riemer, Schmainda, Warnert, Wiegers and Booth.
PY - 2022/3/3
Y1 - 2022/3/3
N2 - Objective: Summarize evidence for use of advanced MRI techniques as monitoring biomarkers in the clinic, and highlight the latest bench-to-bedside developments. Methods: Experts in advanced MRI techniques applied to high-grade glioma treatment response assessment convened through a European framework. Current evidence regarding the potential for monitoring biomarkers in adult high-grade glioma is reviewed, and individual modalities of perfusion, permeability, and microstructure imaging are discussed (in Part 1 of two). In Part 2, we discuss modalities related to metabolism and/or chemical composition, appraise the clinic readiness of the individual modalities, and consider post-processing methodologies involving the combination of MRI approaches (multiparametric imaging) or machine learning (radiomics). Results: High-grade glioma vasculature exhibits increased perfusion, blood volume, and permeability compared with normal brain tissue. Measures of cerebral blood volume derived from dynamic susceptibility contrast-enhanced MRI have consistently provided information about brain tumor growth and response to treatment; it is the most clinically validated advanced technique. Clinical studies have proven the potential of dynamic contrast-enhanced MRI for distinguishing post-treatment related effects from recurrence, but the optimal acquisition protocol, mode of analysis, parameter of highest diagnostic value, and optimal cut-off points remain to be established. Arterial spin labeling techniques do not require the injection of a contrast agent, and repeated measurements of cerebral blood flow can be performed. The absence of potential gadolinium deposition effects allows widespread use in pediatric patients and those with impaired renal function. More data are necessary to establish clinical validity as monitoring biomarkers. Diffusion-weighted imaging, apparent diffusion coefficient analysis, diffusion tensor or kurtosis imaging, intravoxel incoherent motion, and other microstructural modeling approaches also allow treatment response assessment; more robust data are required to validate these alone or when applied to post-processing methodologies. Conclusion: Considerable progress has been made in the development of these monitoring biomarkers. Many techniques are in their infancy, whereas others have generated a larger body of evidence for clinical application.
AB - Objective: Summarize evidence for use of advanced MRI techniques as monitoring biomarkers in the clinic, and highlight the latest bench-to-bedside developments. Methods: Experts in advanced MRI techniques applied to high-grade glioma treatment response assessment convened through a European framework. Current evidence regarding the potential for monitoring biomarkers in adult high-grade glioma is reviewed, and individual modalities of perfusion, permeability, and microstructure imaging are discussed (in Part 1 of two). In Part 2, we discuss modalities related to metabolism and/or chemical composition, appraise the clinic readiness of the individual modalities, and consider post-processing methodologies involving the combination of MRI approaches (multiparametric imaging) or machine learning (radiomics). Results: High-grade glioma vasculature exhibits increased perfusion, blood volume, and permeability compared with normal brain tissue. Measures of cerebral blood volume derived from dynamic susceptibility contrast-enhanced MRI have consistently provided information about brain tumor growth and response to treatment; it is the most clinically validated advanced technique. Clinical studies have proven the potential of dynamic contrast-enhanced MRI for distinguishing post-treatment related effects from recurrence, but the optimal acquisition protocol, mode of analysis, parameter of highest diagnostic value, and optimal cut-off points remain to be established. Arterial spin labeling techniques do not require the injection of a contrast agent, and repeated measurements of cerebral blood flow can be performed. The absence of potential gadolinium deposition effects allows widespread use in pediatric patients and those with impaired renal function. More data are necessary to establish clinical validity as monitoring biomarkers. Diffusion-weighted imaging, apparent diffusion coefficient analysis, diffusion tensor or kurtosis imaging, intravoxel incoherent motion, and other microstructural modeling approaches also allow treatment response assessment; more robust data are required to validate these alone or when applied to post-processing methodologies. Conclusion: Considerable progress has been made in the development of these monitoring biomarkers. Many techniques are in their infancy, whereas others have generated a larger body of evidence for clinical application.
KW - diffusion
KW - glioblastoma
KW - glioma
KW - high-grade glioma
KW - magnetic resonance imaging
KW - monitoring biomarkers
KW - perfusion
KW - pseudoprogression
UR - http://www.scopus.com/inward/record.url?scp=85130752094&partnerID=8YFLogxK
U2 - 10.3389/fonc.2022.810263
DO - 10.3389/fonc.2022.810263
M3 - Review article
C2 - 35359414
AN - SCOPUS:85130752094
SN - 2234-943X
VL - 12
JO - Frontiers in oncology
JF - Frontiers in oncology
M1 - 810263
ER -