Quantitative MR perfusion parameters related to survival time in high-grade gliomas

Sanz-Requena, Roberto; Revert-Ventura, Antonio; Martí-Bonmatí, Luis; Alberich-Bayarri, Ángel; García-Martí, Gracián
December 2013
European Radiology;Dec2013, Vol. 23 Issue 12, p3456
Academic Journal
Objectives: To evaluate the quantitative parameters obtained from dynamic MR T2*-weighted images as predictors of survival taking into consideration the biasing effects of other survival-related covariates. Methods: Thirty-nine patients (60 ± 14 years; survival 267 ± 191 days) with high-grade gliomas (8 grade III, 31 grade IV) were retrospectively included in the study. Additional data incorporated Karnofsky performance scale, tumour resection extension after surgery and type of treatment. Dynamic T2*-weighted MRI was acquired before treatment. Tumour curves were extracted for each voxel, and several quantitative parameters were obtained from the whole tumour volume and the 10 % maximum values. Additional image covariates included the presence of necrosis, single or multiple lesions, and tumour and oedema volumes. The relationship between quantitative parameters and survival was assessed using clusterisation techniques and the log-rank method. Cox regression analysis was used to evaluate each parameter’s predictive value. Results: Only the mean of the 10 % maximum values of the transfer coefficient showed an independent relationship with patient survival (log-rank chi-squared test <0.001, Cox regression P = 0.015), with higher values corresponding to lower survival rates. Conclusions: High maximum transfer coefficient values show an independent statistical relationship with low survival in high-grade glioma patients. This imaging biomarker can be used as a predictor of prognosis. Key Points: • Histological examination is the standard procedure for predicting glioma biological behaviour.• Tumour biopsies may be biased by sample size and location.• Dynamic T2*-weighted MRI quantitative analysis characterises tumour vasculature at the voxel level.• High-transfer constant maximum values are independent predictors of low overall survival.


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