scholarly journals DWI for Monitoring the Acute Response of Malignant Gliomas to Photodynamic Therapy

2019 ◽  
Author(s):  
Y. Fujita ◽  
T. Sasayama ◽  
K. Tanaka ◽  
K. Kyotani ◽  
H. Nagashima ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas ◽  
Acute Response

scholarly journals NI-7 Diffusion-weighted imaging for monitoring acute response and recurrence after photodynamic therapy in malignant gliomas

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi19-vi19
Author(s):  
Yuichi Fujita ◽  
Hiroaki Nagashima ◽  
Kazuhiro Tanaka ◽  
Mitsuru Hashiguchi ◽  
Tomoo Itoh ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Local Recurrence ◽  
Malignant Glioma ◽  
Diffusion Weighted Imaging ◽  
Malignant Gliomas ◽  
Distant Recurrence ◽  
Acute Response ◽  
Diffusion Weighted ◽  
Hyperintense Signal ◽  
Apparent Diffusion

Abstract Background Photodynamic therapy (PDT) subsequent to surgical tumor removal is a novel light-activated localized treatment for malignant glioma. Although PDT provides effective local control, even PDT cannot completely suppress local recurrence of malignant glioma. We previously reported that the acute response of malignant glioma to PDT could be detected as linear hyperintense signals on diffusion-weighted imaging (DWI) and a decline in apparent diffusion coefficient (ADC) values that were asymptomatic and transient. However, their long-term clinical significance has not yet been examined. This study aimed to clarify the link between the hyperintense signal on DWI as an acute response and recurrence after PDT in malignant glioma. Methods Thirty consecutive patients (16 men, 14 women; median age 60.5 years) underwent PDT for malignant glioma at our institution between 2017 and 2020. We analyzed signal changes on DWI after PDT and the link between these findings and the recurrence pattern. Results In all patients, linear hyperintense signals of 5–7 mm on DWI were detected at the surface of the resected cavity from day 1 after PDT. These changes matched the PDT-irradiated area and disappeared in about 30 days without any neurological deterioration. Of the 30 patients, 19 (63%) exhibited recurrence: local recurrence in 10 (33%), distant recurrence in 1 (3%), and dissemination in 8 (27%). All local recurrences arose from areas that did not show a hyperintense signal on DWI obtained on day 1 after PDT. Patients with distant recurrence or dissemination tended to have uninterrupted hyperintense signal on DWI obtained on day 1 after PDT. Conclusion The local recurrence in malignant glioma after PDT occurred in the areas without hyperintense signal on DWI as the acute response to PDT. This characteristic finding could aid in the monitoring of not only PDT-irradiated area but also local recurrence site after PDT.

scholarly journals Hyperintense Signal on Diffusion-Weighted Imaging for Monitoring The Acute Response and Local Recurrence After Photodynamic Therapy in Malignant Gliomas

2021 ◽  
Author(s):  
Yuich Fujita ◽  
Hiroaki Nagashima ◽  
Kazuhiro Tanaka ◽  
Mitsuru Hashiguchi ◽  
Tomoo Itoh ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Local Recurrence ◽  
Malignant Glioma ◽  
Diffusion Weighted Imaging ◽  
Malignant Gliomas ◽  
Acute Response ◽  
Diffusion Weighted ◽  
Hyperintense Signal ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Purpose Photodynamic therapy (PDT) subsequent to surgical tumor removal is a novel localized treatment for malignant glioma that provides effective local control. The acute response of malignant glioma to PDT can be detected as linear transient hyperintense signal on diffusion-weighted imaging (DWI) and a decline in apparent diffusion coefficient (ADC) values without symptoms. However, their long-term clinical significance has not yet been examined. The aim of this study was to clarify the link between hyperintense signal on DWI as an acute response and recurrence after PDT in malignant glioma. Methods Thirty patients (16 men; median age, 60.5 years) underwent PDT for malignant glioma at our institution between 2017 and 2020. We analyzed the signal changes on DWI after PDT and the relationship between these findings and the recurrence pattern. Results All patients showed linear hyperintense signal on DWI at the surface of the resected cavity from day 1 after PDT. These changes disappeared in about 30 days without any neurological deterioration. During a mean post-PDT follow-up of 14.3 months, 19 patients (63%) exhibited recurrence: 10 local, 1 distant, and 8 disseminated. All of the local recurrences arose from areas that did not show hyperintense signal on DWI obtained on day 1 after PDT. Conclusion The local recurrence in malignant glioma after PDT occurs in an area without hyperintense signal on DWI as an acute response to PDT. This characteristic finding could aid in the monitoring of local recurrence after PDT.

Stereotactic Intratumoral Photodynamic Therapy for Recurrent Malignant Brain Tumors

Neurosurgery ◽  
1991 ◽  
Vol 29 (5) ◽  
pp. 688-696 ◽  
Author(s):  
Stephen K. Powers ◽  
Sharon S. Cush ◽  
Diana L. Walstad ◽  
Lester Kwock
Keyword(s):  
Photodynamic Therapy ◽  
Magnetic Resonance ◽  
Malignant Gliomas ◽  
Signs And Symptoms ◽  
Resonance Spectroscopy ◽  
Normal Brain ◽  
Hematoporphyrin Derivative ◽  
Neurological Sequelae ◽  
Computed Tomographic ◽  
Before And After

Abstract Photodynamic therapy (PDT) using purified hematoporphyrin derivative and stereotactic intratumorally implanted optical laser fiber(s) was used to treat patients with recurrent malignant gliomas and metastatic melanoma of the brain. Tumor response to PDT was evaluated by recording changes in the volume and pattern of tumor enhancement between computed tomographic and magnetic resonance imaging scans done before and after PDT, metabolic changes in tumor tissue by31 P magnetic resonance spectroscopy, and patient outcome. Toxicity of PDT to brain was evaluated on the basis of changes in the patients' neurological examinations and correlated with changes in brain adjacent to tumor seen on postoperative imaging studies. Dramatic tumor responses to PDT were seen in all gliomas, but no response of tumor to treatment was seen with melanoma. Transient signs and symptoms of increased peritumoral cerebral edema caused by PDT were seen in all patients. Two patients suffered permanent neurological sequelae, monocular blindness and a partial visual field defect, as a result of treatment. Two patients with recurrent anaplastic astrocytomas remain in remission at 45 and 35 weeks after PDT. We conclude that intratumoral photoradiation therapy of hematoporphyrin derivative-photosensitized malignant gliomas effectively produces necrosis of the solid component of malignant gliomas: however, intratumoral photoradiation may not reach the portion of tumor that invades normal brain.

scholarly journals 362P Influence of the expression of ABCG2 transporters on the results of photodynamic therapy in malignant gliomas

2021 ◽  
Vol 32 ◽  
pp. S523
Author(s):  
A. Rynda ◽  
V. Olyushin ◽  
D. Rostovtsev ◽  
J. Zabrodskaya
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas

Photodynamic Therapy of Malignant Gliomas

2018 ◽  
pp. 1-13 ◽  
Author(s):  
Sadao Kaneko ◽  
Shin Fujimoto ◽  
Hideshi Yamaguchi ◽  
Toru Yamauchi ◽  
Tetsuya Yoshimoto ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas

Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid

2005 ◽  
Author(s):  
Herbert G. Stepp ◽  
Tobias Beck ◽  
Wolfgang Beyer ◽  
Thomas Pongratz ◽  
Ronald Sroka ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Aminolevulinic Acid ◽  
Malignant Gliomas

scholarly journals Photodynamic therapy in the treatment of intracranial gliomas: A review of current practice and considerations for future clinical directions

2015 ◽  
Vol 08 (01) ◽  
pp. 1530005 ◽  
Author(s):  
Carl J. Fisher ◽  
Lothar Lilge
Keyword(s):  
Clinical Trials ◽  
Photodynamic Therapy ◽  
Survival Time ◽  
Malignant Gliomas ◽  
Survival Rates ◽  
Standard Of Care ◽  
Therapeutic Index ◽  
Current Standard ◽  
Significant Survival ◽  
Tumor Volume Reduction

Invasive grade III and IV malignant gliomas remain difficult to treat with a typical survival time post-diagnosis hovering around 16 months with only minor extension thereof seen in the past decade, whereas some improvements have been obtained towards five-year survival rates for which completeness of resection is a prerequisite. Optical techniques such as fluorescence guided resection (FGR) and photodynamic therapy (PDT) are promising adjuvant techniques to increase the tumor volume reduction fraction. PDT has been used in combination with surgical resection or alternatively as standalone treatment strategy with some success in extending the median survival time of patients compared to surgery alone and the current standard of care. This document reviews the outcome of past clinical trials and highlights the general shift in PDT therapeutic approaches. It also looks at the current approaches for interstitial PDT and research options into increasing PDT's glioma treatment efficacy through exploiting both physical and biological-based approaches to maximize PDT selectivity and therapeutic index, particularly in brain adjacent to tumor (BAT). Potential reasons for failing to demonstrate a significant survival advantage in prior PDT clinical trials will become evident in light of the improved understanding of glioma biology and PDT dosimetry.

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