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Evaluation of the implementation of the response assessment in neuro-oncology criteria in the HERBY trial of pediatric patients with newly diagnosed high-grade gliomas

Rodriguez, D.; Chambers, T.; Warmuth-Metz, M.; Sanchez Aliaga, E.; Warren, D.; Calmon, R.; Hargrave, D.; Garcia, J.; Vassal, G.; Grill, J.; Zahlmann, G.; Morgan, P. S.; Jaspan, T.

Authors

D. Rodriguez

T. Chambers

M. Warmuth-Metz

E. Sanchez Aliaga

D. Warren

R. Calmon

D. Hargrave

J. Garcia

G. Vassal

J. Grill

G. Zahlmann

P. S. Morgan

T. Jaspan



Abstract

© 2019 American Society of Neuroradiology. All rights reserved. BACKGROUND AND PURPOSE: HERBY was a Phase II multicenter trial setup to establish the efficacy and safety of adding bevacizumab to radiation therapy and temozolomide in pediatric patients with newly diagnosed non– brain stem high-grade gliomas. This study evaluates the implementation of the radiologic aspects of HERBY. MATERIALS AND METHODS: We analyzed multimodal imaging compliance rates and scan quality for participating sites, adjudication rates and reading times for the central review process, the influence of different Response Assessment in Neuro-Oncology criteria in the final response, the incidence of pseudoprogression, and the benefit of incorporating multimodal imaging into the decision process. RESULTS: Multimodal imaging compliance rates were the following: diffusion, 82%; perfusion, 60%; and spectroscopy, 48%. Neuroradi-ologists’ responses differed for 50% of scans, requiring adjudication, with a total average reading time per patient of approximately 3 hours. Pseudoprogression occurred in 10/116 (9%) cases, 8 in the radiation therapy/temozolomide arm and 2 in the bevacizumab arm (P .01). Increased target enhancing lesion diameter was a reason for progression in 8/86 cases (9.3%) but never the only radiologic or clinical reason. Event-free survival was predicted earlier in 5/86 (5.8%) patients by multimodal imaging (diffusion, n 4; perfusion, n 1). CONCLUSIONS: The addition of multimodal imaging to the response criteria modified the assessment in a small number of cases, determining progression earlier than structural imaging alone. Increased target lesion diameter, accounting for a large proportion of reading time, was never the only reason to designate disease progression.

Citation

Rodriguez, D., Chambers, T., Warmuth-Metz, M., Sanchez Aliaga, E., Warren, D., Calmon, R., …Jaspan, T. (2019). Evaluation of the implementation of the response assessment in neuro-oncology criteria in the HERBY trial of pediatric patients with newly diagnosed high-grade gliomas. American Journal of Neuroradiology, 40(3), 568-575. https://doi.org/10.3174/ajnr.A5982

Journal Article Type Article
Acceptance Date Dec 31, 2018
Online Publication Date Feb 28, 2019
Publication Date Jan 1, 2019
Deposit Date Feb 28, 2019
Publicly Available Date Mar 28, 2024
Journal American Journal of Neuroradiology
Print ISSN 0195-6108
Electronic ISSN 1936-959X
Publisher American Society of Neuroradiology
Peer Reviewed Peer Reviewed
Volume 40
Issue 3
Pages 568-575
DOI https://doi.org/10.3174/ajnr.A5982
Keywords Radiology Nuclear Medicine and imaging; Clinical Neurology
Public URL https://nottingham-repository.worktribe.com/output/1592600
Publisher URL http://www.ajnr.org/content/40/3/568