Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients
The purpose of this work was to prospectively investigate sodium (23Na) MRI at 7 Tesla (T) as predictor of therapy response and survival in patients with glioblastoma (GBM). Thus, 20 GBM patients underwent 23Na MRI at 7T before, immediately after and 6 weeks after chemoradiotherapy (CRT). The median...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:9d0825e26c4148e89c565dfc2960d5e22021-12-01T22:43:32ZAssessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients1662-453X10.3389/fnins.2021.782516https://doaj.org/article/9d0825e26c4148e89c565dfc2960d5e22021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnins.2021.782516/fullhttps://doaj.org/toc/1662-453XThe purpose of this work was to prospectively investigate sodium (23Na) MRI at 7 Tesla (T) as predictor of therapy response and survival in patients with glioblastoma (GBM). Thus, 20 GBM patients underwent 23Na MRI at 7T before, immediately after and 6 weeks after chemoradiotherapy (CRT). The median tissue sodium concentration (TSC) inside the whole tumor excluding necrosis was determined. Initial response to CRT was assessed employing the updated response assessment in neuro-oncology working group (RANO) criteria. Clinical parameters, baseline TSC and longitudinal TSC differences were compared between patients with initial progressive disease (PD) and patients with initial stable disease (SD) using Fisher’s exact tests and Mann-Whitney-U-tests. Univariate proportional hazard models for progression free survival (PFS) and overall survival (OS) were calculated using clinical parameters and TSC metrics as predictor variables. The analyses demonstrated that TSC developed heterogeneously over all patients following CRT. None of the TSC metrics differed significantly between cases of initial SD and initial PD. Furthermore, TSC metrics did not yield a significant association with PFS or OS. Conversely, the initial response according to the RANO criteria could significantly predict PFS [univariate HR (95%CI) = 0.02 (0.0001–0.21), p < 0.001] and OS [univariate HR = 0.17 (0.04–0.65), p = 0.005]. In conclusion, TSC showed treatment-related changes in GBM following CRT, but did not significantly correlate with the initial response according to the RANO criteria, PFS or OS. In contrast, the initial response according to the RANO criteria was a significant predictor of PFS and OS. Future investigations need to elucidate the reasons for treatment-related changes in TSC and their clinical value for response prediction in glioblastoma patients receiving CRT.Daniel PaechSebastian RegnerySebastian RegneryTanja PlattNicolas G. R. BehlNicolas G. R. BehlNina WeckesserPaul WindischKaterina Deike-HofmannWolfgang WickMartin BendszusStefan RiekenStefan RiekenLaila KönigLaila KönigMark E. LaddMark E. LaddHeinz-Peter SchlemmerJürgen DebusJürgen DebusSebastian AdebergSebastian AdebergFrontiers Media S.A.articlebrain neoplasm/secondary casesglioblastomaresponse assessmentmagnetic resonance imagingultra-high field (7 tesla)sodium MRINeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Neuroscience, Vol 15 (2021) |
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| topic |
brain neoplasm/secondary cases glioblastoma response assessment magnetic resonance imaging ultra-high field (7 tesla) sodium MRI Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 |
| spellingShingle |
brain neoplasm/secondary cases glioblastoma response assessment magnetic resonance imaging ultra-high field (7 tesla) sodium MRI Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Daniel Paech Sebastian Regnery Sebastian Regnery Tanja Platt Nicolas G. R. Behl Nicolas G. R. Behl Nina Weckesser Paul Windisch Katerina Deike-Hofmann Wolfgang Wick Martin Bendszus Stefan Rieken Stefan Rieken Laila König Laila König Mark E. Ladd Mark E. Ladd Heinz-Peter Schlemmer Jürgen Debus Jürgen Debus Sebastian Adeberg Sebastian Adeberg Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| description |
The purpose of this work was to prospectively investigate sodium (23Na) MRI at 7 Tesla (T) as predictor of therapy response and survival in patients with glioblastoma (GBM). Thus, 20 GBM patients underwent 23Na MRI at 7T before, immediately after and 6 weeks after chemoradiotherapy (CRT). The median tissue sodium concentration (TSC) inside the whole tumor excluding necrosis was determined. Initial response to CRT was assessed employing the updated response assessment in neuro-oncology working group (RANO) criteria. Clinical parameters, baseline TSC and longitudinal TSC differences were compared between patients with initial progressive disease (PD) and patients with initial stable disease (SD) using Fisher’s exact tests and Mann-Whitney-U-tests. Univariate proportional hazard models for progression free survival (PFS) and overall survival (OS) were calculated using clinical parameters and TSC metrics as predictor variables. The analyses demonstrated that TSC developed heterogeneously over all patients following CRT. None of the TSC metrics differed significantly between cases of initial SD and initial PD. Furthermore, TSC metrics did not yield a significant association with PFS or OS. Conversely, the initial response according to the RANO criteria could significantly predict PFS [univariate HR (95%CI) = 0.02 (0.0001–0.21), p < 0.001] and OS [univariate HR = 0.17 (0.04–0.65), p = 0.005]. In conclusion, TSC showed treatment-related changes in GBM following CRT, but did not significantly correlate with the initial response according to the RANO criteria, PFS or OS. In contrast, the initial response according to the RANO criteria was a significant predictor of PFS and OS. Future investigations need to elucidate the reasons for treatment-related changes in TSC and their clinical value for response prediction in glioblastoma patients receiving CRT. |
| format |
article |
| author |
Daniel Paech Sebastian Regnery Sebastian Regnery Tanja Platt Nicolas G. R. Behl Nicolas G. R. Behl Nina Weckesser Paul Windisch Katerina Deike-Hofmann Wolfgang Wick Martin Bendszus Stefan Rieken Stefan Rieken Laila König Laila König Mark E. Ladd Mark E. Ladd Heinz-Peter Schlemmer Jürgen Debus Jürgen Debus Sebastian Adeberg Sebastian Adeberg |
| author_facet |
Daniel Paech Sebastian Regnery Sebastian Regnery Tanja Platt Nicolas G. R. Behl Nicolas G. R. Behl Nina Weckesser Paul Windisch Katerina Deike-Hofmann Wolfgang Wick Martin Bendszus Stefan Rieken Stefan Rieken Laila König Laila König Mark E. Ladd Mark E. Ladd Heinz-Peter Schlemmer Jürgen Debus Jürgen Debus Sebastian Adeberg Sebastian Adeberg |
| author_sort |
Daniel Paech |
| title |
Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| title_short |
Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| title_full |
Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| title_fullStr |
Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| title_full_unstemmed |
Assessment of Sodium MRI at 7 Tesla as Predictor of Therapy Response and Survival in Glioblastoma Patients |
| title_sort |
assessment of sodium mri at 7 tesla as predictor of therapy response and survival in glioblastoma patients |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/9d0825e26c4148e89c565dfc2960d5e2 |
| work_keys_str_mv |
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