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Glioblastoma treated with concurrent radiation therapy and temozolomide chemotherapy: Differentiation of true progression from pseudoprogression with quantitative dynamic contrast-enhanced MR Imaging

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Title
Glioblastoma treated with concurrent radiation therapy and temozolomide chemotherapy: Differentiation of true progression from pseudoprogression with quantitative dynamic contrast-enhanced MR Imaging
Author(s)
Yun T.J.; Park C.-K.; Kim T.M.; Lee S.-H.; Kim J.-H.; Sohn C.-H.; Park S.-H.; Kim I.H.; Seung Hong Choi
Publication Date
2015-03
Journal
RADIOLOGY, v.274, no.3, pp.830 - 840
Publisher
RADIOLOGICAL SOC NORTH AMERICA
Abstract
Purpose: To explore the role of dynamic contrast material-enhanced magnetic resonance (MR) imaging in the differentiation of true progression from pseudoprogression in patients with glioblastoma on the basis of findings in entirely newly developed or enlarged enhancing lesions after concurrent radiation therapy and chemotherapy with temozolomide and to evaluate the diagnostic performance of the quantitative pharmacokinetic parameters obtained at dynamic contrast-enhanced MR imaging, such as the volume transfer constant (Ktrans), the extravascular extracellular space per unit volume of tissue(ve), and the blood plasma volume per unit volume of tissue(vp). Materials and Methods: This prospective study had institutional review board approval; written informed consent was obtained from all patients. Thirty-three patients with histopathologically proven glioblastoma who had undergone concurrent radiation therapy and chemotherapy with temozolomide were included. Dynamic contrast-enhanced MR imaging-derived pharmacokinetic parameters, including Ktrans, ve, and vp, were calculated for newly developed or enlarged enhancing lesions. Pharmacokinetic parameters were compared between the true progression (n = 17) and pseudoprogression (n = 16) groups by using unpaired t tests and then multivariable analysis.. Results: The mean Ktrans and ve were higher in the true progression group than in the pseudoprogression group (mean Ktrans, 0.44 min-1 ± 0.25 [standard deviation] and 0.23 min21 ± 0.10 for true progression and pseudoprogression groups, respectively, P = .004; and mean ve, 1.26 ± 0.78 and 0.75 ± 0.49 for true progression and pseudoprogression groups, respectively, P = .034). Multivariable analysis showed that mean Ktrans was the only independently differentiating variable (P = .004).. © RSNA, 2014
URI
https://pr.ibs.re.kr/handle/8788114/2080
DOI
10.1148/radiol.14132632
ISSN
0033-8419
Appears in Collections:
Center for Nanoparticle Research(나노입자 연구단) > 1. Journal Papers (저널논문)
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