Evidence map›Paper›PMID 35437259›Full record

ArticleNeurology2022

Conventional MRI Criteria to Differentiate Progressive Disease From Treatment-Induced Effects in High-Grade (WHO Grade 3-4) Gliomas.

Christina M Flies, Karlijn H van Leuken, Marlies Ten Voorde, Joost J C Verhoeff, Filip Y F De Vos, Tatjana Seute, Pierre A Robe, Theodoor D Witkamp, Jeroen Hendrikse, Jan Willem Dankbaar and 1 more

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Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 23% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

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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

11 authors at 1 institution in 1 country.

Christina M FliesFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).ORCID 0000-0002-9160-4058
Karlijn H van LeukenFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Marlies Ten VoordeFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Joost J C VerhoeffFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Filip Y F De VosFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).ORCID 0000-0002-9082-5991
Tatjana SeuteFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Pierre A RobeFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Theodoor D WitkampFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Jeroen HendrikseFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).
Jan Willem DankbaarFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.).ORCID 0000-0003-4646-9587
Tom J SnijdersFrom the Department of Neurology & Neurosurgery, UMC Utrecht Brain Center (C.M.F., K.H.v.L., M.t.V., T.S., P.A.R., T.J.S.), and Departments of Radiation Oncology (J.J.C.V.), Medical Oncology (F.Y.F.D.V.), and Radiology (T.D.W., J.H., J.W.D.), University Medical Center Utrecht; Stichting Beroepsopleiding Huisarts (K.H.v.L.), the Netherlands; and Mission of the Netherlands Reformed Congregations in Guinea (Conakry) (M.t.V.). t.j.snijders@umcutrecht.nl.ORCID 0000-0003-0857-081X
Amsterdam UMC Location Vrije Universiteit Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPosttreatment radiologic deterioration of an irradiated high-grade (WHO grade 3-4) glioma (HGG) may be the result of true progressive disease or treatment-induced effects (TIE). Differentiation between these entities is of great importance but remains a diagnostic challenge. This study assesses the diagnostic value of conventional MRI characteristics to differentiate progressive disease from TIE in HGGs.

methodsIn this single-center, retrospective, consecutive cohort study, we included adults with a HGG who were treated with (chemo-)radiotherapy and subsequently developed a new or increasing contrast-enhancing lesion on conventional follow-up MRI. TIE and progressive disease were defined radiologically as stable/decreased for ≥6 weeks or Response Assessment in Neuro-Oncology progression and histologically as TIE without viable tumor or progressive disease. Two neuroradiologists assessed 21 preselected MRI characteristics of the progressive lesions. The statistical analysis included logistic regression to develop a full multivariable model, a diagnostic model with model reduction, and a Cohen kappa interrater reliability (IRR) coefficient.

resultsA total of 210 patients (median age 61 years, interquartile range 54-68, 189 male) with 284 lesions were included, of whom 141 (50%) had progressive disease. Median time to progressive disease was 2 (0.7-6.1) and to TIE 0.9 (0.7-3.5) months after radiotherapy. After multivariable modeling and model reduction, the following determinants prevailed: radiation dose (odds ratio [OR] 0.68, 95% CI 0.49-0.93), longer time to progression (TTP; OR 3.56, 95% CI 1.84-6.88), marginal enhancement (OR 2.04, 95% CI 1.09-3.83), soap bubble enhancement (OR 2.63, 95% CI 1.39-4.98), and isointense apparent diffusion coefficient (ADC) signal (OR 2.11, 95% CI 1.05-4.24). ORs >1 indicate higher odds of progressive disease. The Hosmer & Lemeshow test showed good calibration ( DISCUSSION: Several characteristics from conventional MRI are significant predictors for the discrimination between progressive disease and TIE. However, IRR was variable. Conventional MRI characteristics from this study should be incorporated into a multimodal diagnostic model with advanced imaging techniques. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with irradiated HGGs, radiation dose, longer TTP, marginal enhancement, soap bubble enhancement, and isointense ADC signal distinguish progressive disease from TIE.

Indexed as

Brain NeoplasmsGliomaAdultCohort StudiesDiffusion Magnetic Resonance ImagingHumansMagnetic Resonance ImagingMaleMiddle AgedReproducibility of ResultsRetrospective StudiesSoapsWorld Health OrganizationSoaps

Identifiers

PMID35437259
PMCPMC9259090
OpenAlexW4224227396

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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.