Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods
Top Cited Papers
Open Access
- 1 March 2014
- journal article
- review article
- Published by Taylor & Francis Ltd in Cancer Management and Research
- Vol. 6, 149-70
- https://doi.org/10.2147/CMAR.S54726
Abstract
Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods Rafay Ahmed,1 Matthew J Oborski,2 Misun Hwang,1 Frank S Lieberman,3 James M Mountz11Department of Radiology, 2Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Neurology and Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies, and importantly, for facilitating patient management, sparing patients from weeks or months of toxicity and ineffective treatment. This review will present an overview of epidemiology, molecular pathogenesis and current advances in diagnoses, and management of malignant gliomas.Keywords: glioblastoma multiforme, malignant gliomas, MRI, PET, FLT, early therapy response assessment, quantitative molecular imagingKeywords
This publication has 98 references indexed in Scilit:
- Epidermal Growth Factor Receptor, Protein Kinase B/Akt, and Glioma Response to ErlotinibJNCI Journal of the National Cancer Institute, 2005
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaThe New England Journal of Medicine, 2005
- Role of the Vascular Endothelial Growth Factor Pathway in Tumor Growth and AngiogenesisJournal of Clinical Oncology, 2005
- Multimodal metabolic imaging of cerebral gliomas: positron emission tomography with [18F]fluoroethyl-l-tyrosine and magnetic resonance spectroscopyJournal of Neurosurgery, 2005
- Incidence Proportions of Brain Metastases in Patients Diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance SystemJournal of Clinical Oncology, 2004
- Occult central nervous system involvement in patients with metastatic breast cancer: prevalence, predictive factors and impact on overall survivalAnnals Of Oncology, 2003
- Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patientsJournal of Magnetic Resonance Imaging, 2002
- Positron emission tomography with injection of methionine as a prognostic factor in gliomaJournal of Neurosurgery, 2001
- Intra-Operative Direct Electrical Stimulations of the Central Nervous System: The Salpêtrière Experience With 60 PatientsActa Neurochirurgica, 1999
- On the Origin of Cancer CellsScience, 1956