Cerebral blood flow changes after radiation therapy identifies pseudoprogression in diffuse intrinsic pontine gliomas.
Calmon R,Puget S,Varlet P,Dangouloff-Ros V,Blauwblomme T,Beccaria K,Grevent D,Sainte-Rose C,Castel D,Debily M,Dufour C,Bolle S,Dhermain F,Saitovitch A,Zilbovicius M,Brunelle F,Grill J,Boddaert N
Source :
Neuro-oncology
2017 Déc 16
Pmid / DOI:
29244086
Abstract
BACKGROUNDThe interval between progression and death in diffuse intrinsic pontine glioma (DIPG) is usually 6 months following so-called pseudoprogression, with a median of 8.9 months and a maximum of 35.6 months. All 43 patients exhibited increased blood volume and flow after radiotherapy, but the 90th percentile of those with signs of pseudoprogression had a greater increase of ASL-CBF (P < 0.001). Survival between the 2 groups did not differ significantly. During true progression, DSCrCBF and DSCrCBV values increased only in patients who had not experienced pseudoprogression.CONCLUSIONSPseudoprogression is a frequent phenomenon in DIPG patients. This condition needs to be recognized before considering treatment discontinuation. In this study, the larger increase of the ASL-CBF ratio after radiotherapy accurately distinguished pseudoprogression from true progression.