神经影像学
胶质母细胞瘤
医学
磁共振弥散成像
模式治疗法
放射基因组学
医学物理学
磁共振成像
人工智能
计算机科学
放射科
无线电技术
内科学
精神科
癌症研究
作者
Laiz Laura de Godoy,Sanjeev Chawla,Steven Brem,Suyash Mohan
标识
DOI:10.1158/1078-0432.ccr-23-0009
摘要
The highly aggressive nature of glioblastoma carries a dismal prognosis despite aggressive multimodal therapy. Alternative treatment regimens, such as immunotherapies, are known to intensify the inflammatory response in the treatment field. Follow-up imaging in these scenarios often mimics disease progression on conventional MRI, making accurate evaluation extremely challenging. To this end, revised criteria for assessment of treatment response in high-grade gliomas were successfully proposed by the RANO Working Group to distinguish pseudoprogression from true progression, with intrinsic constraints related to the post-contrast T1-weighted MRI sequence. To address these existing limitations, our group proposes a more objective and quantifiable "treatment agnostic" model, integrating into the RANO criteria advanced multimodal neuroimaging techniques, such as diffusion tensor imaging (DTI), dynamic susceptibility contrast-perfusion weighted imaging (DSC-PWI), dynamic contrast enhanced (DCE)-MRI , MR spectroscopy, and amino acid-based PET imaging tracers, along with artificial intelligence tools (radiomics, radiogenomics, and radiopathomics) and molecular information to address this complex issue of treatment-related changes versus tumor progression in 'real-time', particularly in the early post-treatment window. Our Perspective delineates the potential of incorporating multimodal neuroimaging techniques to improve consistency and automation for the assessment of early treatment response in neuro-oncology.
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