Changes in Relative Cerebral Blood Volume 1 Month after Radiation-Temozolomide Therapy Can Help Predict Overall Survival in Patients with Glioblastoma
- 1 August 2010
- journal article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 256 (2), 575-584
- https://doi.org/10.1148/radiol.10091440
Abstract
To evaluate perfusion parameter changes in patients with glioblastoma multiforme by comparing the perfusion magnetic resonance (MR) imaging measurements obtained before combined radiation and temozolomide therapy (RT-TMZ) with the follow-up MR imaging measurements obtained 1 month after completion of this treatment. Institutional review board approval was obtained, and HIPAA guidelines were followed. The data of 36 patients (24 male [median age, 63 years]; 12 female [median age, 59 years]) with glioblastoma multiforme who were treated with RT-TMZ were retrospectively reviewed. The hypothesis was that a change in relative cerebral blood volume (rCBV) 1 month after RT-TMZ is predictive of overall survival. Linear regression analysis was performed to correlate changes in tumor size and perfusion parameters with overall survival. Receiver operating characteristic (ROC) curves were evaluated for 1-year survival. Overall survival was assessed with Kaplan-Meir survival curves and log-rank testing. Percentage change in rCBV at 1 month after RT-TMZ correlated with overall survival. Increased rCBV after treatment was a strong predictor of poor survival (median survival, 235 days versus 529 days with decreased rCBV) (P < .008, log-rank test). The ROC curves for 1-year survival showed a greater area under the curve (0.806; 95% confidence interval [CI]: 0.698, 0.970) (P = .005) with rCBV than with tumor size (0.556; 95% CI: 0.342, 0.729) (P = .382). The overall survival for patients with increased tumor size, based on Macdonald criteria, was shorter than that for patients who showed no progression (stable or partial response), but the difference was not significant (median survival, 442 days versus 598 days) (P = .761, log-rank test). Change in rCBV after RT-TMZ appears to correlate with overall survival.This publication has 25 references indexed in Scilit:
- Evaluation of MR markers that predict survival in patients with newly diagnosed GBM prior to adjuvant therapyJournal of Neuro-Oncology, 2008
- Incidence of early pseudo‐progression in a cohort of malignant glioma patients treated with chemoirradiation with temozolomideCancer, 2008
- Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: Pitfalls in neurooncologyNeuro-Oncology, 2008
- Gliomas: Predicting Time to Progression or Survival with Cerebral Blood Volume Measurements at Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR ImagingRadiology, 2008
- Clinical investigation survival prediction in high-grade gliomas by MRI perfusion before and during early stage of RTInternational Journal of Radiation Oncology*Biology*Physics, 2006
- Low-Grade Gliomas: Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging—Prediction of Patient Clinical ResponseRadiology, 2006
- Survival analysis in patients with glioblastoma multiforme: Predictive value of choline‐to‐n‐acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volumeJournal of Magnetic Resonance Imaging, 2004
- Dynamic susceptibility contrast MRI of gliomasNeuroimaging Clinics Of North America, 2002
- Glial Neoplasms: Dynamic Contrast-enhanced T2*-weighted MR ImagingRadiology, 1999
- Recursive Partitioning Analysis of Prognostic Factors in Three Radiation Therapy Oncology Group Malignant Glioma TrialsJNCI Journal of the National Cancer Institute, 1993