Relevance of T2 signal changes in the assessment of progression of glioblastoma according to the Response Assessment in Neurooncology criteria
Background: According to the Response Assessment in Neurooncology (RANO) criteria, significant nonenhancing signal increase in T2-weighted images qualifies for progression in high-grade glioma (T2-progress), even if there is no change in the contrast-enhancing tumor portion. The purpose of this retr...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
February 2012
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| In: |
Neuro-Oncology
Year: 2012, Volume: 14, Issue: 2, Pages: 222-229 |
| ISSN: | 1523-5866 |
| DOI: | 10.1093/neuonc/nor200 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1093/neuonc/nor200 Verlag, Volltext: https://academic.oup.com/neuro-oncology/article/14/2/222/1038873 
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| Author Notes: | Alexander Radbruch, Kira Lutz, Benedikt Wiestler, Philipp Bäumer, Sabine Heiland, Wolfgang Wick, and Martin Bendszus |
| Summary: | Background: According to the Response Assessment in Neurooncology (RANO) criteria, significant nonenhancing signal increase in T2-weighted images qualifies for progression in high-grade glioma (T2-progress), even if there is no change in the contrast-enhancing tumor portion. The purpose of this retrospective study was to assess the frequency of isolated T2-progress and its predictive value on subsequent T1-progress, as determined by a T2 signal increase of 15% or 25%, respectively. The frequency of T2-progress was correlated with antiangiogenic therapy. Patients and Methods: MRI follow-up examinations (n = 777) of 144 patients with histologically proven glioblastoma were assessed for contrast-enhanced T1 and T2-weighted images. Examinations were classified as T1-progress, T2-progress with 15% or 25% T2-signal increase, stable disease, or partial or complete response. Results: Thirty-five examinations revealed exclusive T2-progress using the 15% criterion, and only 2 examinations qualified for the 25% criterion; 61.8% of the scans presenting T2-progress and 31.5% of the scans presenting stable disease revealed T1-progress in the next follow-up examination. The χ2 test showed a highly significant correlation (P < .001) between T2-progress, with the 15% criterion and subsequent T1-progress. No correlation between antiangiogenic therapy and T2-progress was shown. Conclusion: Tumor progression, as determined by both contrast-enhanced T1 and T2 sequences is more frequently diagnosed than when considering only contrast-enhanced T1 sequences. Definition of T2-progress by a 15% T2-signal increase criterion is superior to a 25% criterion. The missing correlation of T2-progress and antiangiogenic therapy supports the hypothesis of T2-progress as part of the natural course of the tumor disease. |
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| Item Description: | Advance access publication December 6, 2011 Gesehen am 26.11.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1523-5866 |
| DOI: | 10.1093/neuonc/nor200 |