Evidence map›Paper›PMID 24523362›Full record

ArticleNeuro-oncology2014

Evaluation of pseudoprogression in patients with glioblastoma multiforme using dynamic magnetic resonance imaging with ferumoxytol calls RANO criteria into question.

Morad Nasseri, Seymur Gahramanov, Joao Prola Netto, Rongwei Fu, Leslie L Muldoon, Csanad Varallyay, Bronwyn E Hamilton, Edward A Neuwelt

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 5 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.

  1. Usefulness ofCancer imaging : the official publication of the International Cancer Imaging Society · 2020
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  14. A histogram of [EJNMMI research · 2024
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  20. Iron Oxide Nanoparticles as TAdvanced materials (Deerfield Beach, Fla.) · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Morad NasseriDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Seymur GahramanovDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Joao Prola NettoDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Rongwei FuDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Leslie L MuldoonDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Csanad VarallyayDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Bronwyn E HamiltonDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Edward A NeuweltDepartment of Neurology, Oregon Health & Science University, Portland, Oregon (M.N., S.G., J.P.N., L.L.M., C.V., E.A.N.); Department of Public Health and Preventative Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon (R.F.); Department of Neuroradiology, Oregon Health & Science University, Portland, Oregon (B.E.H.); Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon (E.A.N.); Department of Veterans Affairs Medical Center, Portland, Oregon (E.A.N.); Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington (S.G.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (M.N.).
Portland VA Medical Center · USSwedish Medical Center · USOregon Health & Science University · USWayne State University · US

Funding

Two Compartment Models to Improve Brain Tumor TherapyR01CA137488 · NCI · OREGON HEALTH & SCIENCE UNIVERSITY · PI NEUWELT, EDWARD A. · 2008 to 2019
$7.3M
Nanoparticle MR Imaging of BBB Inflammation at High Tesla in CNS TumorsR01NS053468 · NINDS · OREGON HEALTH & SCIENCE UNIVERSITY · PI NEUWELT, EDWARD A. · 2007 to 2011
$2.8M
NCI NIH HHS CA137488-15S1NINDS NIH HHS NS053468
6 · The paper itself

Abstract

backgroundDiagnosis of pseudoprogression in patients with glioblastoma multiforme (GBM) is limited by Response Assessment in Neuro-Oncology (RANO) criteria to 3 months after chemoradiotherapy (CRT). Frequency of pseudoprogression occurring beyond this time limit was determined. Survival comparison was made between pseudoprogression and true progression patients as determined by using perfusion magnetic resonance imaging with ferumoxytol (p-MRI-Fe).

methodsFifty-six patients with GBM who demonstrated conventional findings concerning for progression of disease post CRT were enrolled in institutional review board-approved MRI protocols. Dynamic susceptibility-weighted contrast-enhanced p-MRI-Fe was used to distinguish true progression from pseudoprogression using relative cerebral blood volume (rCBV) values. rCBV of 1.75 was assigned as the cutoff value. Participants were followed up using RANO criteria, and survival data were analyzed.

resultsTwenty-seven participants (48.2%) experienced pseudoprogression. Pseudoprogression occurred later than 3 months post CRT in 8 (29.6%) of these 27 participants (ie, 8 [14.3%] of the 56 patients meeting the inclusion criteria). Overall survival was significantly longer in participants with pseudoprogression (35.2 months) compared with those who never experienced pseudoprogression (14.3 months; P < .001).

conclusionsPseudoprogression presented after 3 months post CRT in a considerable portion of patients with GBM, which raises doubts about the value of the 3-month time limit of the RANO criteria. Accurate rCBV measurement (eg, p-MRI-Fe) is suggested when there are radiographical concerns about progression of disease in GBM patients, regardless of any time limit. Pseudoprogression correlates with significantly better survival outcomes.

Indexed as

AdultAgedAged, 80 and overBrain NeoplasmsChemoradiotherapyCombined Modality TherapyDisease ProgressionFemaleFerrosoferric OxideGlioblastomaHumansMagnetic Resonance ImagingMaleMiddle AgedTreatment OutcomeYoung AdultFerrosoferric OxideferumoxytolGBMperfusion-MRIpseudoprogressionRANO criteria

Identifiers

PMID24523362
PMCPMC4096172
OpenAlexW2145848467

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.