Multimodal imaging of brain tumors: treatment planning, prognostication and treatment follow-up with MRI and PET

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    Abstract

    Imaging with conventional MRI plays an essential role in the diagnosis, treatment planning and treatment follow-up of brain tumor patients. However, imaging with conventional MRI has several limitations challenging clinical decision making. This thesis explores the use of multimodal imaging with advanced methods to improve the clinical management of brain tumor patients.

    Part I discusses the treatment planning and prognostication of brain tumor patients. There is a special focus on the anatomical relationship of glioblastoma with the ventricles. Patients with ventricle-contacting glioblastoma have a poorer prognosis compared to patients with non-contacting tumors. This thesis finds that ventricle-contacting glioblastomas demonstrate higher peritumoral perfusion and proliferation rates as demonstrated by advanced imaging methods. These aggressive features possibly explain the survival difference between patients with ventricle contacting and non-contacting glioblastomas.

    Part II emphasizes on the treatment follow-up of glioblastoma patients. Due to the inevitable recurrence of glioblastomas, patients undergo frequent MRI scanning throughout treatment. However, treatment effects such as pseudoprogression can mimic tumor progression on conventional MRI. The inability to accurately differentiate pseudoprogression from tumor progression hinders reliable decision-making regarding continuation or discontinuation of treatment. This thesis demonstrates that multimodal imaging with advanced MRI and PET methods improves the treatment evaluation of glioblastoma patients. The current practice of standard scheduled MRI scans during treatment is also questioned. Pseudoprogression causes a considerable amount of uncertainty on scheduled scans and treatment decisions are often postponed.

    This thesis substantiates the value of multimodal imaging to aid in clinical decision making in brain tumor patients.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    Supervisors/Advisors
    • Dierckx, Rudi, Supervisor
    • van der Hoorn, Anouk, Co-supervisor
    • van Laar, Peter Jan, Co-supervisor
    • Enting, Roelien, Co-supervisor
    Award date24-Aug-2022
    Place of Publication[Groningen]
    Publisher
    DOIs
    Publication statusPublished - 2022

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