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- Title
Imaging timing after surgery for glioblastoma: an evaluation of practice in Great Britain and Ireland (INTERVAL-GB)- a multi-centre, cohort study.
- Authors
Gillespie, Conor S; Bligh, Emily R; Poon, Michael TC; Islim, Abdurrahman I; Solomou, Georgios; Gough, Melissa; Millward, Christopher P; Rominiyi, Ola; Zakaria, Rasheed; Price, Stephen J.; Watts, Colin; Camp, Sophie; Booth, Thomas C; Thompson, Gerard; Mills, Samantha J; Waldman, Adam; Brennan, Paul M.; Jenkinson, Michael D; Abdullmalek, Hidayatul; Abualsaud, Suhaib
- Abstract
Purpose: Post-operative MRI is used to assess extent of resection, monitor treatment response and detect progression in high-grade glioma. However, compliance with accepted guidelines for follow-up MRI, and impact on management/outcomes is unclear. Methods: Multi-center, retrospective observational cohort study of patients with confirmed WHO grade 4 glioma (August 2018-February 2019) receiving oncological treatment. Primary objective: investigate follow-up MRI surveillance practice and compliance with recommendations from NICE (Post-operative scan < 72h, MRI every 3–6 months) and EANO (Post-operative scan < 48h, MRI every 3 months). Results: There were 754 patients from 26 neuro-oncology centers with a median age of 63 years (IQR 54–70), yielding 10,100 (median, 12.5/person, IQR 5.2–19.4) person-months of follow-up. Of patients receiving debulking surgery, most patients had post-operative MRI within 72 h of surgery (78.0%, N = 407/522), and within 48 h of surgery (64.2%, N = 335/522). The median number of subsequent follow-up MRI scans was 1 (IQR 0–4). Compliance with NICE and EANO recommendations for follow-up MRI was 52.8% (N = 398/754) and 24.9% (N = 188/754), respectively. On multivariable Cox regression analysis, increased time spent in recommended follow-up according to NICE guidelines was associated with longer OS (HR 0.56, 95% CI 0.46–0.66, P < 0.001), but not PFS (HR 0.93, 95% CI 0.79–1.10, P = 0.349). Increased time spent in recommended follow-up according to EANO guidelines was associated with longer OS (HR 0.54, 95% CI 0.45–0.63, P < 0.001) but not PFS (HR 0.99, 95% CI 0.84–1.16, P = 0.874). Conclusion: Regular surveillance follow-up for glioblastoma is associated with longer OS. Prospective trials are needed to determine whether regular or symptom-directed MRI influences outcomes.
- Subjects
MAGNETIC resonance imaging; REGRESSION analysis; GLIOBLASTOMA multiforme; GLIOMAS; COHORT analysis
- Publication
Journal of Neuro-Oncology, 2024, Vol 169, Issue 2, p517
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-024-04705-3