ArticleNeuro-oncology2025
Impact of corticosteroid administration on contrast-enhancing volume and diffusion MRI in treatment naïve glioblastoma.
Article in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient-reported outcomes as prognostic indicators for overall survival and progression-free survival in brain tumor patients - a systematic review and meta-analysis of randomized clinical trials.Journal of neuro-oncology · 2026Pooled it
- Monitoring glioblastoma dynamics during chemoradiation on the 1.5 T magnetic resonance imaging-linear accelerator.Clinical and translational radiation oncology · 2026Article
- Clinical outcomes and quality of life in glioblastoma patients treated with MR-guided adaptive radiotherapy using a 1.5 T MR-Linac in an Australian setting.Clinical and translational radiation oncology · 2026Article
- Radiomic analysis of the peritumoral zone identifies imaging signatures of glioma invasion associated with HSP70 expression.Frontiers in oncology · 2026Article
- Impact of corticosteroid administration on glioblastoma progression before and after adjuvant treatments: recent updates on contradictory findings and mechanistic interactions.Frontiers in oncology · 2026Review
- Influence of corticosteroids on contrast enhancement in patients with untreated glioblastoma.Neuro-oncology · 2025Article
- Association between time to surgery and survival in patients with initially diagnosed WHO 2021 grade 4 gliomas.Neuro-oncology advancesArticle
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13 authors.
Funding
Abstract
backgroundCorticosteroids impact the radiographic interpretation of glioblastoma, including artificial reduction in the contrast-enhancing tumor volume and intensity (i.e., a "pseudoresponse") and in the apparent diffusion coefficient (ADC). This study aimed to estimate the influence of corticosteroids on these measurements in treatment naïve glioblastoma before surgery.
methodsFifty-seven pairs of MRI scans from 54 patients with presurgical treatment-naïve glioblastoma were retrospectively grouped as increased (n = 29, all corticosteroid-free at baseline), stable (n = 25), or decreased (n = 3) corticosteroid dose between scans (median interval: 15 days). Tumor size and ADC changes between timepoints were compared between lesions with increased and stable corticosteroids. Volumetric changes ascribable to increased corticosteroid dose was modeled, adjusting for the time between scans.
resultsIncreased corticosteroid dose showed an observed volumetric shrinkage of the contrast-enhancing tumor (median: -23.7%) and reduction in estimated growth rates (median: -2.48% per day), significantly different (P < .0001) from the control group receiving a stable dose (median: +36.0% volume; +2.08% growth rate). When adjusting for the time interval between scans, the estimated corticosteroid-induced volumetric shrinkage was 44.0% (P < .0001, 95% CI, 25.7%-62.2%). Increased corticosteroid dose also decreased ADC in the contrast-enhancing tumor (median reduction: 180, IQR = 39 - 281 × 10-6 mm2/s, P = .0005).
conclusionCorticosteroid administration can induce a significant "pseudoresponse" in glioblastoma, with an observed reduction in contrast-enhancing tumor volume of 23.7% and a time interval adjusted reduction of 44.0% (25.7%-62.2%), and an ADC drop of 180 × 10-6 mm2/s (14.2%). These data confirm that radiographic measurements are impacted by corticosteroids and provide benchmarks for the development of adjusted response criteria accounting for corticosteroid use.
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