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Clinical Applications of Contrast-Enhanced Perfusion MRI Techniques in Gliomas: Recent Advances and Current Challenges

机译:胶质瘤对比增强灌注MRI技术的临床应用:最新进展和当前挑战

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摘要

Gliomas possess complex and heterogeneous vasculatures with abnormal hemodynamics. Despite considerable advances in diagnostic and therapeutic techniques for improving tumor management and patient care in recent years, the prognosis of malignant gliomas remains dismal. Perfusion-weighted magnetic resonance imaging techniques that could noninvasively provide superior information on vascular functionality have attracted much attention for evaluating brain tumors. However, nonconsensus imaging protocols and postprocessing analysis among different institutions impede their integration into standard-of-care imaging in clinic. And there have been very few studies providing a comprehensive evidence-based and systematic summary. This review first outlines the status of glioma theranostics and tumor-associated vascular pathology and then presents an overview of the principles of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast-MRI (DSC-MRI), with emphasis on their recent clinical applications in gliomas including tumor grading, identification of molecular characteristics, differentiation of glioma from other brain tumors, treatment response assessment, and predicting prognosis. Current challenges and future perspectives are also highlighted.
机译:神经胶质瘤具有复杂且异质的脉管系统,血液动力学异常。尽管近年来在改善肿瘤管理和患者护理的诊断和治疗技术上取得了巨大进步,但恶性神经胶质瘤的预后仍然令人沮丧。可以无创地提供有关血管功能的优质信息的灌注加权磁共振成像技术已引起人们对评估脑肿瘤的广泛关注。然而,不同机构之间的非共识成像协议和后处理分析阻碍了它们整合到临床护理标准成像中。很少有研究提供全面的基于证据的系统总结。这篇综述首先概述了神经胶质瘤治疗学和肿瘤相关血管病理学的现状,然后概述了动态对比增强MRI(DCE-MRI)和动态敏感性对比MRI(DSC-MRI)的原理。最近在神经胶质瘤中的临床应用包括肿瘤分级,分子特征的鉴定,神经胶质瘤与其他脑肿瘤的区分,治疗反应评估以及预测预后。还强调了当前的挑战和未来的前景。

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