Taming Glioblastoma in 'Real Time': Integrating Multimodal Advanced Neuroimaging/AI Tools Towards Creating a Robust and Therapy Agnostic Model for Response Assessment in Neuro-Oncology".
Laiz Laura de GodoySeung-Cheol LeeSteven BremSuyash MohanPublished in: Clinical cancer research : an official journal of the American Association for Cancer Research (2023)
The highly aggressive nature of glioblastoma carries a dismal prognosis despite aggressive multimodal therapy. Alternative treatment regimens, such as immunotherapies, are known to intensify the inflammatory response in the treatment field. Follow-up imaging in these scenarios often mimics disease progression on conventional MRI, making accurate evaluation extremely challenging. To this end, revised criteria for assessment of treatment response in high-grade gliomas were successfully proposed by the RANO Working Group to distinguish pseudoprogression from true progression, with intrinsic constraints related to the post-contrast T1-weighted MRI sequence. To address these existing limitations, our group proposes a more objective and quantifiable "treatment agnostic" model, integrating into the RANO criteria advanced multimodal neuroimaging techniques, such as diffusion tensor imaging (DTI), dynamic susceptibility contrast-perfusion weighted imaging (DSC-PWI), dynamic contrast enhanced (DCE)-MRI , MR spectroscopy, and amino acid-based PET imaging tracers, along with artificial intelligence tools (radiomics, radiogenomics, and radiopathomics) and molecular information to address this complex issue of treatment-related changes versus tumor progression in 'real-time', particularly in the early post-treatment window. Our Perspective delineates the potential of incorporating multimodal neuroimaging techniques to improve consistency and automation for the assessment of early treatment response in neuro-oncology.
Keyphrases
- contrast enhanced
- artificial intelligence
- inflammatory response
- high grade
- magnetic resonance imaging
- high resolution
- amino acid
- magnetic resonance
- pet imaging
- computed tomography
- healthcare
- palliative care
- risk assessment
- big data
- squamous cell carcinoma
- combination therapy
- mesenchymal stem cells
- pain management
- single molecule
- deep learning
- multiple sclerosis
- drug induced
- human health
- low grade
- clinical evaluation