Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dempsey, M. F. Articles by Hadley, D. M. Search for Related Content PubMed PubMed Citation Articles by Dempsey, M. F. Articles by Hadley, D. M.

American Journal of Neuroradiology 26:770-776, April 2005
© 2005 American Society of Neuroradiology

BRAIN

Measurement of Tumor "Size" in Recurrent Malignant Glioma: 1D, 2D, or 3D?

Mary F. Dempsey^a, Barrie R. Condon^a and Donald M. Hadley^b

^a Department of Clinical Physics, Institute of Neurological Sciences, Southern General Hospital, Glasgow
^b Department of Neuroradiology, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Address correspondence to Mary Frances Dempsey, Department of Clinical Physics, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF

BACKGROUND AND PURPOSE: Tumor "size" is used internationally as a surrogate marker for overall survival when following current response assessment protocols (World Health Organization and Response Evaluation Criteria in Solid Tumors). With little evidence of a relationship between tumor "size" and survival in intrinsic brain tumors, this study was undertaken to investigate the predictive value of MR imaging–defined tumor size for survival in patients with recurrent malignant glioma and to compare the different measures of tumor size used in these current response assessment protocols.

METHODS: Volumetric, bidimensional, and unidimensional measurements of tumor size were made using baseline contrast-enhanced T1-weighted images of 70 patients with recurrent malignant glioma receiving intravenous chemotherapy. Cox’s proportional hazards model was used to investigate the prognostic importance of tumor size using survival as the end point. Further statistical analysis was undertaken to investigate the relationship between the different measurement techniques.

RESULTS: Only the volumetric measurement of tumor size was found to be predictive of survival in recurrent malignant glioma on both univariate and multivariate analysis. Furthermore, analysis demonstrated that the unidimensional and bidimensional measures of tumor were not comparable with the more accurate and direct volumetric measurement.

CONCLUSION: Indirect unidimensional and bidimensional measurement techniques do not have a significant association with overall survival or adequately assess tumor size in recurrent malignant glioma. These findings have serious implications about the validity of using current response assessment protocols in therapy trials for recurrent malignant glioma.

This article has been cited by other articles:

				D. A. Hamstra, C. J. Galban, C. R. Meyer, T. D. Johnson, P. C. Sundgren, C. Tsien, T. S. Lawrence, L. Junck, D. J. Ross, A. Rehemtulla, et al. Functional Diffusion Map As an Early Imaging Biomarker for High-Grade Glioma: Correlation With Conventional Radiologic Response and Overall Survival J. Clin. Oncol., July 10, 2008; 26(20): 3387 - 3394. [Abstract] [Full Text] [PDF]

				N. U. Lin and E. P. Winer Brain Metastases: The HER2 Paradigm Clin. Cancer Res., March 15, 2007; 13(6): 1648 - 1655. [Abstract] [Full Text] [PDF]