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Contrast‐enhancing tumor growth dynamics of preoperative, treatment‐naive human glioblastoma
Author(s) -
Ellingson Benjamin M.,
Nguyen Huytram N.,
Lai Albert,
Nechifor Ruben E.,
Zaw Okkar,
Pope Whitney B.,
Yong William H.,
Nghiemphu Phioanh L.,
Liau Linda M.,
Cloughesy Timothy F.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29957
Subject(s) - medicine , doubling time , magnetic resonance imaging , glioblastoma , nuclear medicine , lesion , progressive disease , radiology , surgery , disease , cancer research , biochemistry , chemistry , in vitro
BACKGROUND Little is known about the natural growth characteristics of untreated glioblastoma before surgical or therapeutic intervention, because patients are rapidly treated after preliminary radiographic diagnosis. Understanding the growth characteristics of uninhibited human glioblastoma may be useful for characterizing changes in response to therapy. Thus, the objective of the current study was to explore tumor growth dynamics in a cohort of patients with untreated glioblastoma before surgical or therapeutic intervention. METHODS Ninety‐five patients with glioblastoma who had measurable enhancing disease on >2 magnetic resonance imaging scans before surgery were identified. Tumor growth rates were quantified in 4 different ways (the percentage change per day, the absolute rate of change per day, the estimated volumetric doubling time, and the radial expansion rate) using 3 different approaches (bidirectional product, enhancing disease, and total lesion volume). RESULTS The median volumetric doubling time was 21.1 days, the percentage change in tumor volume was 2.1% per day, and the rate of change in total lesion volume was 0.18 cc per day. The length of follow‐up between magnetic resonance imaging examinations should be >28 days to detect progressive disease with high specificity. Small initial tumor sizes (<3 cm in greatest dimension) are biased toward a large percentage change at follow‐up. CONCLUSIONS Presurgical, treatment‐naive glioblastoma growth dynamics can be estimated in a variety of ways with similar results. The percentage changes in tumor size and volume depend on baseline tumor size and the time interval between scans. Cancer 2016;122:1718‐27 . © 2016 American Cancer Society .