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Abstract Details

Diagnostic Imaging Workup of Acute Ischemic Stroke in Glioblastoma Patients
Cerebrovascular Disease and Interventional Neurology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
4-015
To evaluate the radiographic stroke workup of adult glioblastoma patients with acute ischemic stroke.
Cerebrovascular complications are common in glioblastoma patients, both in the perioperative period and throughout the course of disease. Ischemic strokes can occur secondary to various conventional vascular risk factors, or multiple tumor-specific or treatment-related mechanisms. We hypothesized that a substantial number of high-grade glioma patients do not undergo comprehensive imaging workup following an ischemic stroke.
In this single academic referral center, retrospective analysis of all adult glioblastoma patients ≥ 18 years of age seen by the Neuro-Oncology Department between 1/2000 through 12/2018 was performed. Patients diagnosed with an acute ischemic stroke after cancer diagnosis date were defined by validated ICD-9/10 codes, natural language processing of radiographic reports or clinical notes. Diagnostic stroke workup completed within 7 days of the acute ischemic stroke event was extracted from the research database and confirmed with chart review. Post-operative strokes were defined as those occurring within 7 days of surgery.
A total of 64 glioblastoma patients who suffered at least one acute ischemic stroke were identified. Baseline characteristics included 69% male, aged 22-83 years old. The majority of strokes were discovered incidentally on imaging (75%), while a minority of patients were symptomatic at presentation (25%). 42 strokes occurred post-operatively (67%). MRI was the first imaging study used to diagnose ischemic stroke (94%), while only 4 patients underwent Computed Tomography (CT) first (6%). 14% of patients had vessel imaging: 3 patients with CT angiography (CTA) (5%), 3 with MR angiography (MRA) (5%), and 3 with Carotid Doppler Ultrasound (CDUS) (5%).
Despite the high incidence of thromboembolic complications, there is no standardized approach to the imaging workup of glioblastoma patients suffering ischemic stroke. Thus patients can be undertreated and vulnerable to recurrent events, poor functional outcomes and increased mortality.
Authors/Disclosures
Ashley Becker, MD
PRESENTER 		Dr. Becker has nothing to disclose.
Alexandra L. Czap, MD (University of Texas Health Science Center At Houston) The institution of Dr. Czap has received research support from SVIN. The institution of Dr. Czap has received research support from Â鶹´«Ã½Ó³»­.
No disclosure on file
No disclosure on file
James C. Grotta, MD, FÂ鶹´«Ã½Ó³»­ (Memorial Hermann Hospital Life Flight) Dr. Grotta has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Frazer Ltd. Dr. Grotta has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Haemonetics. Dr. Grotta has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acticor. Dr. Grotta has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prolong Pharma. Dr. Grotta has received publishing royalties from a publication relating to health care. Dr. Grotta has received publishing royalties from a publication relating to health care.
Louise D. McCullough, MD, PhD (McGovern Medical School, UTHealth) The institution of Dr. McCullough has received research support from NIH. The institution of Dr. McCullough has received research support from American Heart Association.
John F. De Groot, MD (UC San Francisco Medical Center) An immediate family member of Dr. De Groot has received personal compensation for serving as an employee of Ziopharm Oncology. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Celldex. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Deciphera Pharmaceuticals. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AbbVie. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for FivePrime Therapeutics, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GW Pharma. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Carthera. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kadmon. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Biomedical Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Taiho Pharmaceuticals. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kairos Venture Investments. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Syneos Health. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Monteris. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Agios. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mundipharma Research. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GenomiCare. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Blue Earth Diagnostics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Del Mar Pharmaceuticals. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Insightec. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Voyager Therapeutics, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck & Co.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Tocagen. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bioasis Technologies, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ResTORbio, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celldex. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Foundation Medicine, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novogen. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Deciphera. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astrazeneca. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Insys Therapeutics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck & Co.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lily. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novella Clinical. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Karyopharm Therapeutics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Blue Earth Diagnostics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kiyatec. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vanquish Oncology. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orsenix, Insightec. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prelude Therapeutics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Debiopharm Therapeutics, Inc.. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen Global Services, LLC. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for VBL Therapeutics. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novella. Dr. De Groot has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for VBI Vaccines, Inc.. An immediate family member of Dr. De Groot has received stock or an ownership interest from Ziopharm Oncology. An immediate family member of Dr. De Groot has received stock or an ownership interest from Gilead. The institution of Dr. De Groot has received research support from Carthera. The institution of Dr. De Groot has received research support from HaiHe Pharma. The institution of Dr. De Groot has received research support from Taiho Pharma.