Gliomas, the most common malignant brain tumors in adults, can be difficult to treat because of their aggressive and invasive nature. In treating patients with gliomas, it is increasingly important that doctors be able to detect tumor changes early when there's a better chance for recovery.
According to researchers at Wake Forest Baptist Medical Center, a relatively new type of magnetic resonance imaging (MRI), known as MRI perfusion imaging, can be used to help determine if the disease has progressed by showing evidence of abnormal blood vessel formation, a marker for cancer.
"Being able to 'look at' how blood goes to the tumor area can help doctors make better treatment decisions," said Annette Johnson, M.D., associate professor of radiology at Wake Forest Baptist and principal investigator of the study. "After treatment for brain tumor, which often includes surgery, radiation therapy and chemotherapy, the area of the original tumor will often continue to look abnormal on conventional MRI. This does not necessarily mean that the tumor has returned. MRI perfusion imaging can help tell the difference between the expected effects of successful treatment and tumor regrowth."
The goal of the prospective study, which is published in the March issue of the American Journal of Neuroradiology, was to determine whether a multidisciplinary team of doctors would find MRI perfusion imaging useful in treatment decisions for patients with gliomas.
A total of 59 adult patients with suspected gliomas were evaluated at multiple sessions over 11 months. The team of doctors assessed tumor status and created hypothetical treatment plans, using conventional MRI and then conventional MRI plus perfusion imaging.
The study showed that doctors' treatment plans changed in 8.5 percent of patients and that confidence in treatment plans increased in 57.6 percent of the cases when MRI perfusion imaging was added. These findings suggest that MRI perfusion imaging has significant impact on clinical decision-making and tumor specialists' confidence in treatment plans for patients with gliomas.
Even experienced and highly specialized brain cancer experts often find perfusion imaging helpful in complex treatment decisions in patients with gliomas, Johnson said.
"Our study suggests that people with brain tumors should be getting this new type of imaging," Johnson said. "It may not be best practice anymore to use conventional MRI alone."
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