Pretreatment dynamic contrast-enhanced MRI biomarkers correlate with progression-free survival in primary central nervous system lymphoma Journal Article


Authors: Hatzoglou, V.; Oh, J. H.; Buck, O.; Lin, X.; Lee, M.; Shukla-Dave, A.; Young, R. J.; Peck, K. K.; Vachha, B.; Holodny, A. I.; Grommes, C.
Article Title: Pretreatment dynamic contrast-enhanced MRI biomarkers correlate with progression-free survival in primary central nervous system lymphoma
Abstract: Purpose: Prediction of clinical outcomes in patients with primary central nervous system lymphoma (PCNSL) is important for optimization of treatment planning. Quantitative imaging biomarkers for PCNSL have not yet been established. This study evaluated the prognostic value of pretreatment dynamic contrast-enhanced MRI and diffusion-weighted imaging for progression-free survival (PFS) in patients with PCNSL. Methods: Pretreatment dynamic contrast-enhanced MRI and diffusion-weighted imaging were retrospectively analyzed in 18 immunocompetent patients with PCNSL. Volumes of interest encompassing the tumors were assessed for measurements of blood plasma volume (Vp), volume transfer constant (Ktrans), and apparent diffusion coefficient. Patients were divided into short and long PFS groups based on median PFS. Imaging and clinical variables were correlated with PFS. Results: Median PFS was 19.6 months. Lower Vpmean and Ktrans mean values increased risk for rapid progression (< 19.6 months). Receiver operating characteristic curve analysis demonstrated an optimal Vpmean cutoff value of 2.29 (area under the curve [AUC] = 0.74, sensitivity and specificity = 0.78, p = 0.023) for separating patients with short and long PFS. The optimal Ktrans mean cutoff was 0.08 (AUC = 0.74, sensitivity = 0.67, specificity = 0.78, p = 0.025). Kaplan–Meier survival analysis with log-rank test demonstrated significantly (p = 0.015) increased risk of rapid progression for patients with Vpmean < 2.29. Vpmean was significantly (p = 0.03) associated with PFS on univariate Cox analysis. Apparent diffusion coefficient values and clinical factors did not influence PFS. Conclusions: Pretreatment Vp and Ktrans derived from dynamic contrast-enhanced MRI may be novel prognostic quantitative imaging biomarkers of progression-free survival in patients with PCNSL. These data should be prospectively validated in larger patient cohorts. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: survival; primary cns lymphoma; prognostic biomarker; brain imaging; perfusion mri
Journal Title: Journal of Neuro-Oncology
Volume: 140
Issue: 2
ISSN: 0167-594X
Publisher: Springer  
Date Published: 2018-11-01
Start Page: 351
End Page: 358
Language: English
DOI: 10.1007/s11060-018-2960-z
PROVIDER: scopus
PUBMED: 30073640
DOI/URL:
Notes: J. Neuro-Oncol. -- Export Date: 2 January 2019 -- Article -- CODEN: JNODD C2 - 30073640 -- Source: Scopus
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MSK Authors
  1. Robert J Young
    106 Young
  2. Christian Grommes
    48 Grommes
  3. Amita Dave
    76 Dave
  4. Kyung Peck
    77 Peck
  5. Jung Hun Oh
    110 Oh
  6. Andrei Holodny
    135 Holodny
  7. Xuling   Lin
    9 Lin
  8. Behroze Adi Vachha
    10 Vachha
  9. Olivia Buck
    2 Buck