Permeability Map to Distinguish Progression From Pseudoprogression in High-Grade Glioma
Permeability Map to Distinguish Progression From Pseudoprogression in High-Grade Glioma
The aim of the present study is to assess whether a new method of quantifying
 therapy-associated hemodynamic alterations based on DCE MR imaging may help to distinguish
 pseudoprogression from true progression in patients with high grade glioma, who received
 CCRT.
Combination temozolomide and radiation significantly prolongs survival compared with
 radiation alone and has become standard treatment for glioblastoma multiforme (GBM). Response
 assessment in GBM is difficult as a result of the frequent occurrence of early imaging
 changes indistinguishable from tumor progression, termed pseudoprogression. The majority of
 patients remain clinically stable. It is often unclear whether current therapy should be
 maintained or second-line therapy initiated. The incidence of pseudoprogression after
 concurrent chemoradiation is15%to 30%. A potential mechanism of pseudoprogression is that
 radiation-induced vascular changes may lead to focal transient increase in gadolinium
 enhancement. Dynamic contrast-enhanced (DCE) MR imaging provides a noninvasive means for
 quantifying tumor vascular properties.
Inclusion Criteria:

 -  Among the patients with high-grade glioma (glioblastoma multiforme or anaplastic
 astrocytoma), who received concurrent chemoradiation (CCRT) with temozolomide, the
 patients show the measurable enhancing portion (1 cm in the long diameter according to
 the RANO criteria) in the immediate f/up MRI after CCRT.

 Exclusion Criteria:

 -  Among the patients with high-grade glioma (glioblastoma multiforme or anaplastic
 astrocytoma), who received concurrent chemoradiation (CCRT) with temozolomide, the
 patients do not show the measurable enhancing portion (1 cm in the long diameter
 according to the RANO criteria) in the immediate f/up MRI after CCRT.