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Ahmed R, Oborski MJ, Hwang M, et al. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods. Cancer Manag Res. 2014;6:149-70doi: 10.2147/CMAR.S54726.
Ahmed, R., Oborski, M. J., Hwang, M., Lieberman, F. S., & Mountz, J. M. (2014). Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods. Cancer management and research, 6149-70. https://doi.org/10.2147/CMAR.S54726
Ahmed, Rafay, et al. "Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods." Cancer management and research vol. 6 (2014): 149-70. doi: https://doi.org/10.2147/CMAR.S54726
Ahmed R, Oborski MJ, Hwang M, Lieberman FS, Mountz JM. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods. Cancer Manag Res. 2014 Mar 24;6:149-70. doi: 10.2147/CMAR.S54726. eCollection 2014. PMID: 24711712; PMCID: PMC3969256.
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Cancer Manag Res. 2014 Mar 24;6:149-70. doi: 10.2147/CMAR.S54726. eCollection 2014.

Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods.

Cancer management and research

Rafay Ahmed, Matthew J Oborski, Misun Hwang, Frank S Lieberman, James M Mountz

Affiliations

  1. Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA.
  2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
  3. Department of Neurology and Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

PMID: 24711712 PMCID: PMC3969256 DOI: 10.2147/CMAR.S54726

Abstract

Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12-15 months for glioblastomas and 2-5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies, and importantly, for facilitating patient management, sparing patients from weeks or months of toxicity and ineffective treatment. This review will present an overview of epidemiology, molecular pathogenesis and current advances in diagnoses, and management of malignant gliomas.

Keywords: FLT; MRI; PET; early therapy response assessment; glioblastoma multiforme; malignant gliomas; quantitative molecular imaging

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