title: A novel tool to analyze MRI recurrence patterns in glioblastoma.
abstract: At least 10% of glioblastoma relapses occur at distant and even contralateral locations. This disseminated growth limits surgical intervention and contributes to neurological morbidity. Preclinical data pointed toward a role for temozolomide (TMZ) in reducing radiotherapy-induced glioma cell invasiveness. Our objective was to develop and validate a new analysis tool of MRI data to examine the clinical recurrence pattern of glioblastomas. MRIcro software was used to map the location and extent of initial preoperative and recurrent tumors on MRI of 63 patients in the European Organisation for Research and Treatment of Cancer (EORTC) 26981/22981/National Cancer Institute of Canada (NCIC) CE.3 study into the same stereotaxic space. This allowed us to examine changes of site and distance between the initial and the recurrent tumor on the group level. Thirty of the 63 patients were treated using radiotherapy, while the other patients completed a radiotherapy-plus-TMZ treatment. Baseline characteristics (median age, KPS) and outcome data (progression-free survival, overall survival) of the patients included in this analysis resemble those of the general study cohort. The patient groups did not differ in the promoter methylation status of methyl guanine methyltransferase (MGMT). Overall frequency of distant recurrences was 20%. Analysis of recurrence patterns revealed no difference between the groups in the size of the recurrent tumor or in the differential effect on the distance of the recurrences from the preoperative tumor location. The data show the feasibility of groupwise recurrence pattern analysis. An effect of TMZ treatment on the recurrence pattern in the EORTC 26981/22981/NCIC CE.3 study could not be demonstrated.
authors.affiliation: Department of Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. wolfgang.wick@med.uni-heidelberg.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
authors.forename: Roger
authors.initials: R
authors.lastname: Stupp
authors.forename: Anna-Carina
authors.initials: AC
authors.lastname: Beule
authors.forename: Jacoline
authors.initials: J
authors.lastname: Bromberg
authors.forename: Antje
authors.initials: A
authors.lastname: Wick
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ernemann
authors.forename: Michael
authors.initials: M
authors.lastname: Platten
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Warren P
authors.initials: WP
authors.lastname: Mason
authors.forename: Martin
authors.initials: M
authors.lastname: van den Bent
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.forename: Chris
authors.initials: C
authors.lastname: Rorden
authors.forename: Hans-Otto
authors.initials: HO
authors.lastname: Karnath
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011859:Radiography; D011878:Radiotherapy; D016032:Randomized Controlled Trials as Topic; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide