Assessment of early response to tumor-treating fields in newly diagnosed glioblastoma using physiologic and metabolic MRI: initial experience

CNS Oncol. 2016 Jul;5(3):137-44. doi: 10.2217/cns-2016-0003. Epub 2016 Apr 14.

Abstract

Tumor-treating fields (TTFields) is a novel antimitotic treatment modality for patients with glioblastoma. To assess response to TTFields, a newly diagnosed patient with glioblastoma underwent diffusion, perfusion and 3D echo-planar spectroscopic imaging prior to initiation of TTFields plus temozolamide (baseline) and at 1- and 2-month follow-up periods. Increased mean diffusivity along with decreased fractional anisotropy and maximum relative cerebral blood volume were noted at 2 months relative to baseline suggesting inhibition of tumor growth and angiogenesis. Additionally, a reduction in choline/creatine was also noted during this period. These preliminary data indicate the potential of physiologic and metabolic MRI in assessing early treatment response to TTFields in combination with temozolamide.

Keywords: diffusion tensor imaging; echo-planar spectroscopic imaging; glioblastoma; perfusion-weighted imaging; therapeutic response; tumor-treating fields.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anisotropy
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / drug therapy*
  • Cerebral Blood Volume / drug effects
  • Cerebral Blood Volume / physiology
  • Choline / metabolism
  • Creatine / metabolism
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Electric Stimulation Therapy
  • Electromagnetic Fields*
  • Female
  • Follow-Up Studies
  • Glioblastoma* / diagnostic imaging
  • Glioblastoma* / drug therapy
  • Glioblastoma* / radiotherapy
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Temozolomide
  • Thalamus / diagnostic imaging

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Creatine
  • Choline
  • Temozolomide