Diagnosis of pseudoprogression using ferumoxytol perfusion MRI in patients with glioblastoma to predict better outcome.

2010 Background: This retrospective IRB approved study determined the survival of GBM patients with or without pseudoprogression. Methods: Patients with histologically-proven newly diagnosed GBM at Oregon Health and Science University from January 2006 to June 2012 after standard CRT received adjuvant temozolomide (TMZ) until tumor progression. Diagnosis of pseudoprogression was made by perfusion MRI with ferumoxytol (an iron oxide nanoparticle) and updated Response Assessment in Neuro-Oncology Working Group (RANO) criteria. Survival was determined using Kaplan-Meier product limit analysis and Cox regression model. Results: A total of 68 patients were included. The overall median survival was 19.9 months (95% CI 15.1-22.5). Median survival in 24 (35.3%) patients with pseudoprogression was 34.7 months (95% CI 20.3-54.1), significantly longer than the 13.4 months (95% CI 11.1-19.5) in 44 (64.7%) patients without pseudoprogression (P<0.0001). The longest survival was seen in patients with combination of pseu...