title: Identification of a candidate biomarker from perfusion MRI to anticipate glioblastoma progression after chemoradiation.
abstract: OBJECTIVE
  To identify relevant relative cerebral blood volume biomarkers from T2* dynamic-susceptibility contrast magnetic resonance imaging to anticipate glioblastoma progression after chemoradiation.
  
  
  METHODS
  Twenty-five patients from a prospective study with glioblastoma, primarily treated by chemoradiation, were included. According to the last follow-up MRI confirmed status, patients were divided into: relapse group (n = 13) and control group (n = 12). The time of last MR acquisition was tend; MR acquisitions performed at tend-2M, tend-4Mand tend-6M(respectively 2, 4 and 6 months before tend) were analyzed to extract relevant variations among eleven perfusion biomarkers (B). These variations were assessed through R(B), as the absolute value of the ratio between ∆B from tend-4Mto tend-2Mand ∆B from tend-6Mto tend-4M. The optimal cut-off for R(B) was determined using receiver-operating-characteristic curve analysis.
  
  
  RESULTS
  The fraction of hypoperfused tumor volume (F_hPg) was a relevant biomarker. A ratio R(F_hPg) ≥ 0.61 would have been able to anticipate relapse at the next follow-up with a sensitivity/specificity/accuracy of 92.3 %/63.6 %/79.2 %. High R(F_hPg) (≥0.61) was associated with more relapse at tendcompared to low R(F_hPg) (75 % vs 12.5 %, p = 0.008).
  
  
  CONCLUSIONS
  Iterative analysis of F_hPgfrom consecutive examinations could provide surrogate markers to predict progression at the next follow-up.
  
  
  CONCLUSIONS
  • Related rCBV biomarkers from DSC were assessed to anticipate GBM progression. • Biomarkers were assessed through their patterns of variation during the follow-up. • The fraction of hypoperfused tumour volume (F_hPg) seemed to be a relevant biomarker. • An innovative ratio R(F_hPg) could be an early surrogate marker of relapse. • A significant time gain could be achieved in the management of GBM patients.
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France. jonathan.khalifa@hotmail.fr.|Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France. jonathan.khalifa@hotmail.fr.
authors: J
authors: J
authors: Khalifa
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.
authors: F
authors: F
authors: Tensaouti
authors: Department of Biostatistics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.
authors: L
authors: L
authors: Chaltiel
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France.
authors: J-A
authors: JA
authors: Lotterie
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Department of Radiology, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France.
authors: I
authors: I
authors: Catalaa
authors: Department of Radiation Oncology, Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon, France.
authors: M P
authors: MP
authors: Sunyach
authors: CERMEP - Imagerie du Vivant, Lyon, France.
authors: D
authors: D
authors: Ibarrola
authors: Department of Radiation Oncology, Centre Paul Strauss, EA 3430, University of Strasbourg, 3 rue de la Porte de l'Hôpital, 67065, Strasbourg, France.
authors: G
authors: G
authors: Noël
authors: Department of Radiation Oncology, Centre Georges-François Leclerc, 1 rue Professeur Marion, 21079, Dijon, France.
authors: G
authors: G
authors: Truc
authors: Laboratory of Electronics, Computer Science and Imaging (Le2I), UMR 6306 CNRS, University of Burgundy, Dijon, France.
authors: P
authors: P
authors: Walker
authors: Department of Radiation Oncology, Institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, 42271, Saint-Priest-en-Jarez, France.
authors: N
authors: N
authors: Magné
authors: Department of Radiation Oncology, Institut du Cancer de Montpellier, 208 avenue des Apothicaires, parc Euromédecine, 34298, Montpellier cedex 5, France.
authors: M
authors: M
authors: Charissoux
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Department of Medical Physics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.
authors: S
authors: S
authors: Ken
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France.
authors: P
authors: P
authors: Peran
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France.|Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France.
authors: I
authors: I
authors: Berry
authors: Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.|Université Toulouse III Paul Sabatier, 31000, Toulouse, France.|INSERM U1037, Centre de Recherches contre le Cancer de Toulouse, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.
authors: E Cohen-Jonathan
authors: EC
authors: Moyal
authors: INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.|Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.|Université Toulouse III Paul Sabatier, 31000, Toulouse, France.
authors: A
authors: A
authors: Laprie
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D001810:Blood Volume; D001932:Brain Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D003287:Contrast Media
keywords: Biomarker; Glioblastoma; Perfusion weighted magnetic resonance imaging; Radiotherapy; rCBV