Post-treatment Changes of Tumour Perfusion Parameters Can Help to Predict Survival in Patients with High-grade Astrocytoma

Overview

Journal Eur Radiol

Specialty Radiology

Date 2016 Dec 22

PMID 27999986

Citations 2

Authors

Roberto Sanz-Requena

Antonio J Revert-Ventura

Gracian Garcia-Marti

Fares Salame-Gamarra

Alexandre Perez-Girbes

Enrique Molla-Olmos

Luis Marti-Bonmati

Affiliations

Soon will be listed here.

Abstract

Objectives: Vascular characteristics of tumour and peritumoral volumes of high-grade gliomas change with treatment. This work evaluates the variations of T2*-weighted perfusion parameters as overall survival (OS) predictors.

Methods: Forty-five patients with histologically confirmed high-grade astrocytoma (8 grade III and 37 grade IV) were included. All patients underwent pre- and post-treatment T2*-weighted contrast-enhanced magnetic resonance (MR) imaging. Tumour, peritumoral and control volumes were segmented. Relative variations of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), K, k, v and v were calculated. Differences regarding tumour grade and surgical resection extension were evaluated with ANOVA tests. For each parameter, two groups were defined by non-supervised clusterisation. Survival analysis were performed on these groups.

Results: For the tumour region, the 90th percentile increase or stagnation of CBV was associated with shorter survival, while a decrease related to longer survival (393 ± 189 vs 594 ± 294 days; log-rank p = 0.019; Cox hazard-ratio, 2.31; 95% confidence interval [CI], 1.12-4.74). K showed similar results (414 ± 177 vs 553 ± 312 days; log-rank p = 0.037; hazard-ratio, 2.19; 95% CI, 1.03-4.65). The peritumoral area values showed no relationship with OS.

Conclusions: Post-treatment variations of the highest CBV and K values in the tumour volume are predictive factors of OS in patients with high-grade gliomas.

Key Points: • Vascular characteristics of high-grade glioma tumour and peritumoral regions change with treatment. • Quantitative assessment of MRI perfusion provides valuable information regarding tumour aggressiveness. • Quantitative T2*-weighted perfusion parameters can help to predict overall survival. • Post-treatment variations of CBV and K values are predictive factors of OS. • Increased values may justify treatment intensification in these patients.

Citing Articles

Hemodynamic Imaging in Cerebral Diffuse Glioma-Part B: Molecular Correlates, Treatment Effect Monitoring, Prognosis, and Future Directions.

Stumpo V, Guida L, Bellomo J, van Niftrik C, Sebok M, Berhouma M Cancers (Basel). 2022; 14(5).

PMID: 35267650 PMC: 8909110. DOI: 10.3390/cancers14051342.

Prediction value of unmeasurable MR enhancement at early stage after gross-total resection on the survival state of patients with high-grade glioma.

Quan G, Zheng Y, Chen J, Hua B, Ji X, Zhang K J Neurooncol. 2018; 140(2):359-366.

PMID: 30182160 DOI: 10.1007/s11060-018-2961-y.

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