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Glioblastoma oncometry
L Harisiadis1, K Wechsler-Jentzsch, S Harisiadis
1Department of Radiology, George Washington University Medical Center, Washington, D.C.
Summary
Glioblastoma tumor volume often changes after radiation therapy, impacting treatment planning. Repeat imaging is crucial for accurate boost field adjustments to avoid geographic misses.
Area of Science:
- Neuroncology
- Radiotherapy Physics
- Medical Imaging
Background:
- Glioblastomas require radiation therapy.
- Assessing treatment response is critical.
Purpose of the Study:
- To evaluate changes in glioblastoma computed tomography (CT) appearance post-radiation therapy.
- To determine the prognostic value of early volume changes.
- To assess implications for boost field treatment planning.
Main Methods:
- Prospective study of 20 glioblastoma patients.
- Comparison of interval CT scans with baseline studies after 4000-4500 cGy whole brain radiation.
- Analysis of tumor volume changes and enhancing rim alterations.
Main Results:
- Tumor volume increased in 60% of patients (mean 126%) and decreased in 35% (mean 37%).
- Volume changes did not predict prognosis.
- Increased tumor volume necessitated potential boost field size adjustments, risking geographic miss.
Conclusions:
- Significant glioblastoma volume changes occur after whole brain radiation therapy.
- Early volume changes are not prognostic indicators.
- Repeat CT or MRI is essential for optimal boost field planning after initial radiation therapy.