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. 2021 May;31(5):2933-2943.
doi: 10.1007/s00330-020-07387-3. Epub 2020 Nov 5.

Glioblastoma post-operative imaging in neuro-oncology: current UK practice (GIN CUP study)

Thomas C Booth  1   2 , Aysha Luis  3   4 , Lucy Brazil  5 , Gerry Thompson  6 , Rachel A Daniel  3 , Haris Shuaib  7   8 , Keyoumars Ashkan  9 , Anmol Pandey  10
Affiliations

Glioblastoma post-operative imaging in neuro-oncology: current UK practice (GIN CUP study)

Thomas C Booth et al. Eur Radiol. 2021 May.

Abstract

Objectives: MRI remains the preferred imaging investigation for glioblastoma. Appropriate and timely neuroimaging in the follow-up period is considered to be important in making management decisions. There is a paucity of evidence-based information in current UK, European and international guidelines regarding the optimal timing and type of neuroimaging following initial neurosurgical treatment. This study assessed the current imaging practices amongst UK neuro-oncology centres, thus providing baseline data and informing future practice.

Methods: The lead neuro-oncologist, neuroradiologist and neurosurgeon from every UK neuro-oncology centre were invited to complete an online survey. Participants were asked about current and ideal imaging practices following initial treatment.

Results: Ninety-two participants from all 31 neuro-oncology centres completed the survey (100% response rate). Most centres routinely performed an early post-operative MRI (87%, 27/31), whereas only a third performed a pre-radiotherapy MRI (32%, 10/31). The number and timing of scans routinely performed during adjuvant TMZ treatment varied widely between centres. At the end of the adjuvant period, most centres performed an MRI (71%, 22/31), followed by monitoring scans at 3 monthly intervals (81%, 25/31). Additional short-interval imaging was carried out in cases of possible pseudoprogression in most centres (71%, 22/31). Routine use of advanced imaging was infrequent; however, the addition of advanced sequences was the most popular suggestion for ideal imaging practice, followed by changes in the timing of EPMRI.

Conclusion: Variations in neuroimaging practices exist after initial glioblastoma treatment within the UK. Multicentre, longitudinal, prospective trials are needed to define the optimal imaging schedule for assessment.

Key points: • Variations in imaging practices exist in the frequency, timing and type of interval neuroimaging after initial treatment of glioblastoma within the UK. • Large, multicentre, longitudinal, prospective trials are needed to define the optimal imaging schedule for assessment.

Keywords: Glioblastoma; Guideline; Neuroimaging; Survey.

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Conflict of interest statement

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Figures

Fig. 1
Fig. 1
Percentage of centres that perform MRI at the different time points. All centres performed MRI after adjuvant TMZ, most centres performed MRI early post-operatively and during adjuvant TMZ treatment, whereas only 32% of centres routinely performed pre-radiotherapy MRI. TMZ = temozolomide
Fig. 2
Fig. 2
Imaging protocols at the different time points. Where the standardised protocol was described, most centres used diffusion weighted imaging (DWI), apart from at the pre-radiotherapy time point. Note that the figure shows the percentage of centres that routinely used advanced imaging techniques, as opposed to centres that only used advanced imaging techniques in selected patients, Structural = pre- and post-contrast T1-weighted, T2-weighted, FLAIR; DWI = diffusion weighted imaging; DSC = dynamic susceptibility contrast-enhanced MRI (perfusion); DCE = dynamic contrast enhanced MRI (permeability); 1H-MRS = 1H-MR spectroscopy
See this image and copyright information in PMC

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