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Top Magn Reson Imaging. 2015 Jun;24(3):127-36. doi: 10.1097/RMR.0000000000000054.

Response Assessment and Magnetic Resonance Imaging Issues for Clinical Trials Involving High-Grade Gliomas.

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From the *Department of Diagnostic Imaging, Rhode Island Hospital; and †Alpert Medical School of Brown University, Providence, RI; and ‡Departments of Radiological Sciences and Biomedical Physics, and UCLA Neuro-Oncology Program, David Geffen School of Medicine at UCLA; and §Department of Bioengineering, Henri Samueli School of Engineering and Applied Sciences at UCLA, Los Angeles, CA.


There exist multiple challenges associated with the current response assessment criteria for high-grade gliomas, including the uncertain role of changes in nonenhancing T2 hyperintensity, and the phenomena of pseudoresponse and pseudoprogression in the setting of antiangiogenic and chemoradiation therapies, respectively. Advanced physiological magnetic resonance imaging (MRI), including diffusion and perfusion (dynamic susceptibility contrast MRI and dynamic contrast-enhanced MRI) sensitive techniques for overcoming response assessment challenges, has been proposed, with their own potential advantages and inherent shortcomings. Measurement variability exists for conventional and advanced MRI techniques, necessitating the standardization of image acquisition parameters in order to establish the utility of these imaging methods in multicenter trials for high-grade gliomas. This review chapter highlights the important features of MRI in clinical brain tumor trials, focusing on the current state of response assessment in brain tumors, advanced imaging techniques that may provide additional value for determining response, and imaging issues to be considered for multicenter trials.

[Indexed for MEDLINE]

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