Advanced imaging prompts treatment changes for nearly half of high-grade glioma patients
New research calls for greater utilization of advanced imaging in post-treatment protocols for patients with high-grade glioma (HGG).
A new paper in the American Journal of Roentgenology examines the effect advanced neuroimaging techniques, like perfusion and spectroscopy, have on treatment management of fast-growing HGGs. The study’s results indicate that the addition of advanced imaging after patients have undergone treatment changes how oncologists manage subsequent treatment plans in as many as 44% of HGG cases—a finding that warrants further consideration, authors of the study suggested.
“Advanced neuroimaging has been increasingly integrated into routine follow-up protocols for HGG. This clinical integration benefits from knowledge of which patients with HGG would most benefit from these techniques. Appropriate patient selection would not only influence clinical practice guidelines, but also help ensure cost-effective resource utilization,” corresponding author Melissa M. Chen, MD, from the neuroradiology department at the University of Texas MD Anderson Cancer, and colleagues noted, adding that these techniques are costly and resource intensive.
To get a better idea of how advanced post-treatment imaging affects patient management, the group examined the cases of 66 patients diagnosed with stage 4 diffuse glioma, each of whom had undergone advanced imaging after chemoradiation. The neuro-oncologists who ordered the exams were surveyed before and after to observe how the imaging results affected their intended treatment plans.
Patients completed a total of 70 advanced imaging sessions. In 44% of cases, these sessions prompted providers to change their initial treatment plans. Such changes included enrolling patients in clinical trials, switching chemotherapy agents, and sending patients for surgery or another round of radiation therapy.
In nearly all instances (93%) providers found the additional imaging helpful.
While the authors suggested that their findings support routinely incorporating advanced techniques into post-treatment monitoring protocols for HGG patients, they acknowledged that they were unable to offer greater insight into which patients would benefit the most.
“The frequency of management changes was not significantly associated with type of HGG, stage of glioma therapy, or number of completed chemotherapy cycles,” the group explained. “Future work could focus on further refining the subpopulation of patients who would most strongly benefit from advanced neuroimaging, determining the timing and frequency of advanced neuroimaging examinations, as well as understanding the contexts in which the various advanced neuroimaging techniques should be performed.”
The study abstract is available here.