Dataset Information

Glioblastoma post-operative imaging in neuro-oncology: current UK practice (GIN CUP study).

ABSTRACT:

Objectives

MRI remains the preferred imaging investigation for glioblastoma. Appropriate and timely neuroimaging in the follow-up period is considered to be important in making management decisions. There is a paucity of evidence-based information in current UK, European and international guidelines regarding the optimal timing and type of neuroimaging following initial neurosurgical treatment. This study assessed the current imaging practices amongst UK neuro-oncology centres, thus providing baseline data and informing future practice.

Methods

The lead neuro-oncologist, neuroradiologist and neurosurgeon from every UK neuro-oncology centre were invited to complete an online survey. Participants were asked about current and ideal imaging practices following initial treatment.

Results

Ninety-two participants from all 31 neuro-oncology centres completed the survey (100% response rate). Most centres routinely performed an early post-operative MRI (87%, 27/31), whereas only a third performed a pre-radiotherapy MRI (32%, 10/31). The number and timing of scans routinely performed during adjuvant TMZ treatment varied widely between centres. At the end of the adjuvant period, most centres performed an MRI (71%, 22/31), followed by monitoring scans at 3 monthly intervals (81%, 25/31). Additional short-interval imaging was carried out in cases of possible pseudoprogression in most centres (71%, 22/31). Routine use of advanced imaging was infrequent; however, the addition of advanced sequences was the most popular suggestion for ideal imaging practice, followed by changes in the timing of EPMRI.

Conclusion

Variations in neuroimaging practices exist after initial glioblastoma treatment within the UK. Multicentre, longitudinal, prospective trials are needed to define the optimal imaging schedule for assessment.

Key points

• Variations in imaging practices exist in the frequency, timing and type of interval neuroimaging after initial treatment of glioblastoma within the UK. • Large, multicentre, longitudinal, prospective trials are needed to define the optimal imaging schedule for assessment.

SUBMITTER: Booth TC

PROVIDER: S-EPMC8043861 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe aims of this study were to investigate the role of the Neurological Assessment of Neuro-Oncology (NANO) scale in predicting the prognosis of patients with glioblastoma, and compare these results to predicted data of the Karnofsky Performance Scale (KPS), and Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance status. Additionally, we examined other prognostic factors in glioblastoma patients.MethodsThe medical records of 76 patients with a new diagnosis of histologically ascertained glioblastoma in the period from January 2002 to December 2015 at the authors' institution were retrospectively reviewed. Clinical factors, including epidemiologic, radiologic, and therapeutic values were reviewed as well as the performance status assessed by the KPS, ECOG/WHO performance status, and NANO scale.ResultsThe mean overall survival was 19.8 months (95% confidence interval 15.2-25.4 months). At initial diagnosis, the mean value [±standard deviation (SD)] of KPS score, ECOG/WHO performance status, and NANO scale were 81 (±7.4), 1.3 (±0.6), and 7.3 (±3.8), respectively. Multivariate analysis for predicting survival showed odds ratios of KPS score, ECOG/WHO performance status, and NANO scale were 2.502 (?80 vs. <80; p=0.024), 1.691 (0-1 vs. 2-5; p=0.047), and 2.763 (0-7 vs. 8-23; p=0.020), respectively. At the time of progression, the mean value (±SD) of KPS score, ECOG/WHO performance status, and NANO scale were 69 (±8.2), 1.6 (±0.7), and 11.4 (±4.2), respectively; multivariate analysis for predicting survival showed that the odd ratios for KPS score, ECOG/WHO performance status, and NANO scale were 2.007 (?80 vs. <80; p=0.035), 1.321 (0-1 vs. 2-5; p=0.143), and 3.182 (0-7 vs. 8-23; p=0.002), respectively.ConclusionThe NANO scale provided a more detailed and objective measure of neurologic function than that currently used for predicting the prognosis of glioblastoma patients, especially at the time of progression.