Shukla Gaurav, Alexander Gregory S, Bakas Spyridon, Nikam Rahul, Talekar Kiran, Palmer Joshua D, Shi Wenyin
Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA; Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Richards Medical Research Laboratories, Philadelphia, PA 19104, USA.
Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Chin Clin Oncol. 2017 Aug;6(4):40. doi: 10.21037/cco.2017.06.28.
Glioblastoma, the most common and most rapidly progressing primary malignant tumor of the central nervous system, continues to portend a dismal prognosis, despite improvements in diagnostic and therapeutic strategies over the last 20 years. The standard of care radiographic characterization of glioblastoma is magnetic resonance imaging (MRI), which is a widely utilized examination in the diagnosis and post-treatment management of patients with glioblastoma. Basic MRI modalities available from any clinical scanner, including native T1-weighted (T1w) and contrast-enhanced (T1CE), T2-weighted (T2w), and T2-fluid-attenuated inversion recovery (T2-FLAIR) sequences, provide critical clinical information about various processes in the tumor environment. In the last decade, advanced MRI modalities are increasingly utilized to further characterize glioblastomas more comprehensively. These include multi-parametric MRI sequences, such as dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE), higher order diffusion techniques such as diffusion tensor imaging (DTI), and MR spectroscopy (MRS). Significant efforts are ongoing to implement these advanced imaging modalities into improved clinical workflows and personalized therapy approaches. Functional MRI (fMRI) and tractography are increasingly being used to identify eloquent cortices and important tracts to minimize postsurgical neuro-deficits. A contemporary review of the application of standard and advanced MRI in clinical neuro-oncologic practice is presented here.
胶质母细胞瘤是中枢神经系统最常见且进展最迅速的原发性恶性肿瘤，尽管在过去20年里诊断和治疗策略有所改进，但其预后仍然不佳。胶质母细胞瘤的标准影像学特征检查是磁共振成像（MRI），这是胶质母细胞瘤患者诊断和治疗后管理中广泛使用的一项检查。任何临床扫描仪都能提供的基本MRI模式，包括平扫T1加权（T1w）、增强扫描（T1CE）、T2加权（T2w）以及T2液体衰减反转恢复（T2-FLAIR）序列，可提供有关肿瘤环境中各种过程的关键临床信息。在过去十年中，先进的MRI模式越来越多地被用于更全面地进一步描述胶质母细胞瘤的特征。这些模式包括多参数MRI序列，如动态磁敏感对比增强（DSC）、动态对比增强（DCE）、高阶扩散技术如扩散张量成像（DTI）以及磁共振波谱（MRS）。目前正在做出重大努力，将这些先进的成像模式应用于改进临床工作流程和个性化治疗方法中。功能MRI（fMRI）和神经纤维束成像越来越多地用于识别明确的皮层和重要神经束，以尽量减少术后神经功能缺损。本文对标准和先进MRI在临床神经肿瘤学实践中的应用进行了当代综述。
