IRM de perfusion, de perméabilité et morphologique: Application en radiothérapie neuro-oncologique

F. Dhermain

    Résultats de recherche: Contribution à un journalArticle 'review'Revue par des pairs

    3 Citations (Scopus)

    Résumé

    There is no clear consensus for tumour volume definition in radiotherapy of brain tumours, particularly for high-grade gliomas (HGG). They are infiltrative and heterogeneous, sub-populations of low and high grade can coexist inside one tumour volume, and peritumoral oedema is partly due to a vasogenic mechanism but also to a microscopic extension of sparse tumour cells. All these characteristics are not directly detectable using a conventional MR imaging (MRI). Complementary to the anatomical sequences (T1/T2), still always mandatory, functional maps using the dynamic MRI with a T2* weighted sequence reflect micro-vessel perfusion and permeability, more on a quantitative aspect and a qualitative one, respectively. These parameters better appreciate neo-vascularity of gliomas and areas associated with a higher value of perfusion are clearly correlated with a higher grade. Even a low-grade glioma but with detectable areas of high permeability presents a two-fold risk of recurrence versus another one with the same anatomical characteristics and treatment, but without any micro-vascular leakage. For high-grade gliomas, a high level of tissue perfusion seems to be better predictive for the risk of recurrence than histology itself. The exact co-registration of anatomic and vascular maps is currently available in clinical practice and can be incorporated during the dedicated brain MRI for radiotherapy. Its potential for better predicting the exact sites of recurrence after treatment has to be prospectively evaluated and a strong interest for a dose-escalating study is evident. Finally, T2* dynamic MRI has the ability to differentiate post-treatment modifications from recurrence better than conventional imaging.

    Titre traduit de la contributionRole of perfusion, vascular permeability and anatomic MR imaging in radiation therapy for gliomas
    langue originaleFrançais
    Pages (de - à)753-758
    Nombre de pages6
    journalBulletin du Cancer
    Volume97
    Numéro de publication7
    Les DOIs
    étatPublié - 1 janv. 2010

    mots-clés

    • Anatomic
    • Glioma
    • MR
    • Perfusion MR
    • Radiotherapy
    • Vascular permeability

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