The Concepts, Diagnosis and Management of Early Imaging Changes after Therapy for Glioblastomas

被引:25
作者
Sanghera, P. [2 ]
Rampling, R. [1 ]
Haylock, B. [3 ]
Jefferies, S. [4 ]
McBain, C. [5 ]
Rees, J. H. [6 ,9 ]
Soh, C. [7 ]
Whittle, I. R. [8 ]
机构
[1] Beatson W Scotland Canc Ctr, Dept Oncol, Glasgow, Lanark, Scotland
[2] Queen Elizabeth Hosp, Hall Edwards Radiotherapy Res Grp, Birmingham B15 2TH, W Midlands, England
[3] Clatterbridge Ctr Oncol, Wirral, Merseyside, England
[4] Addenbrookes Hosp, Dept Oncol, Cambridge, England
[5] Christie NHS Fdn Trust, Dept Clin Oncol, Manchester, Lancs, England
[6] Natl Hosp Neurol & Neurosurg, London WC1N 3BG, England
[7] Salford Royal Fdn Trust, Dept Neuroradiol, Salford, Lancs, England
[8] Western Gen Hosp, Dept Clin Neurosci, Edinburgh EH4 2XU, Midlothian, Scotland
[9] UCL Inst Neurol, London, England
关键词
Glioblastoma; MRI; pseudoprogression; temozolomide; BLOOD-BRAIN-BARRIER; HIGH-GRADE GLIOMAS; CENTRAL-NERVOUS-SYSTEM; H-1; MR-SPECTROSCOPY; MALIGNANT GLIOMA; RADIATION NECROSIS; PHASE-II; ENDOTHELIAL-CELLS; INDUCED APOPTOSIS; TUMOR RECURRENCE;
D O I
10.1016/j.clon.2011.06.004
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Since postoperative radiotherapy plus concomitant temozolomide followed by adjuvant temozolomide has become standard treatment for glioblastoma, the phenomenon of early post-treatment enlargement of the imaged tumour volume, usually without clinical deterioration, has become widely recognised. The term pseudoprogression has been used to describe a poorly understood pathophysiological process. In this review, the pathophysiological concepts, relevance, diagnosis and management of patients with 'pseudoprogression' and 'pseudoresponse' are discussed. Guidelines are given with respect to radiological imaging modality, mode and frequency. Further biological and clinical insights into these phenomena require carefully designed prospective studies. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:216 / 227
页数:12
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