{"doi":"10.3390/tomography9010029","title":"A Novel Approach to Determining Tumor Progression Using a Three-Site Pilot Clinical Trial of Spectroscopic MRI-Guided Radiation Dose Escalation in Glioblastoma","abstract":"Glioblastoma (GBM) is a fatal disease, with poor prognosis exacerbated by difficulty in assessing tumor extent with imaging. Spectroscopic MRI (sMRI) is a non-contrast imaging technique measuring endogenous metabolite levels of the brain that can serve as biomarkers for tumor extension. We completed a three-site study to assess survival benefits of GBM patients when treated with escalated radiation dose guided by metabolic abnormalities in sMRI. Escalated radiation led to complex post-treatment imaging, requiring unique approaches to discern tumor progression from radiation-related treatment effect through our quantitative imaging platform. The purpose of this study is to determine true tumor recurrence timepoints for patients in our dose-escalation multisite study using novel methodology and to report on median progression-free survival (PFS). Follow-up imaging for all 30 trial patients were collected, lesion volumes segmented and graphed, and imaging uploaded to our platform for visual interpretation. Eighteen months post-enrollment, the median PFS was 16.6 months with a median time to follow-up of 20.3 months. With this new treatment paradigm, incidence rate of tumor recurrence one year from treatment is 30% compared to 60-70% failure under standard care. Based on the delayed tumor progression and improved survival, a randomized phase II trial is under development (EAF211).","journal":"Tomography","year":2023,"id":387397,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":442400,"name":"Vicki Huang","orcid":"0000-0003-3029-4700","position":1,"is_corresponding":false},{"id":1156164,"name":"Jeffrey Rosenthal","orcid":"0000-0002-0924-666X","position":2,"is_corresponding":false},{"id":318014,"name":"Eric A. Mellon","orcid":"0000-0001-9892-8402","position":3,"is_corresponding":false},{"id":388235,"name":"Mohammed Goryawala","orcid":"0000-0002-6875-2191","position":4,"is_corresponding":false},{"id":256332,"name":"Peter B. Barker","orcid":"0000-0002-6410-7793","position":5,"is_corresponding":false},{"id":428904,"name":"Saumya Gurbani","orcid":"0000-0003-3524-3726","position":6,"is_corresponding":false},{"id":1071580,"name":"Anuradha G. Trivedi","orcid":"0000-0002-3348-4529","position":7,"is_corresponding":false},{"id":1146007,"name":"Alexander S. Giuffrida","orcid":"0000-0001-6512-0992","position":8,"is_corresponding":false},{"id":626629,"name":"Eduard Schreibmann","orcid":null,"position":9,"is_corresponding":false},{"id":1156165,"name":"Hui Han","orcid":"0000-0003-4440-4421","position":10,"is_corresponding":false},{"id":882756,"name":"Macarena de le Fuente","orcid":null,"position":11,"is_corresponding":false},{"id":714703,"name":"Erin Dunbar","orcid":null,"position":12,"is_corresponding":false},{"id":62902,"name":"Matthias Holdhoff","orcid":"0000-0002-3285-3484","position":13,"is_corresponding":false},{"id":250706,"name":"Lawrence Kleinberg","orcid":"0000-0003-2473-2305","position":14,"is_corresponding":false},{"id":294153,"name":"Hui‐Kuo G. Shu","orcid":"0000-0002-4060-0874","position":15,"is_corresponding":false},{"id":375815,"name":"Hyunsuk Shim","orcid":"0000-0001-8313-2612","position":16,"is_corresponding":false},{"id":428905,"name":"Brent D. Weinberg","orcid":"0000-0002-7992-1747","position":17,"is_corresponding":false},{"id":810789,"name":"Karthik K. Ramesh","orcid":null,"position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T01:18:04.706547Z","pmid":"36828381","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}