Gliomas: Predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging Journal Article


Authors: Law, M.; Young, R. J.; Babb, J. S.; Peccerelli, N.; Chheang, S.; Gruber, M. L.; Miller, D. C.; Golfinos, J. G.; Zagzag, D.; Johnson, G.
Article Title: Gliomas: Predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging
Abstract: Purpose: To retrospectively determine whether relative cerebral blood volume (CBV) measurements can be used to predict clinical outcome in patients with high-grade gliomas (HGGs) and low-grade gliomas (LGGs) and specifically whether patients who have gliomas with a high initial relative CBV have more rapid progression than those who have gliomas with a low relative CBV. Materials and Methods: Approval for this retrospective HIPAA-compliant study was obtained from the Institutional Board of Research Associates, with waiver of informed consent. One hundred eighty-nine patients (122 male and 67 female patients; median age, 43 years; range, 4-80 years) were examined with dynamic susceptibility-weighted contrast material-enhanced perfusion magnetic resonance (MR) imaging and were followed up clinically with MR imaging (median follow-up, 334 days). Log-rank tests were used to evaluate the association between relative CBV and time to progression by using Kaplan-Meier curves. Binary logistic regression was used to determine whether age, sex, and relative CBV were associated with an adverse event (progressive disease or death). Results: Values for the mean relative CBV for patients according to each clinical response were as follows: 1.41 ± 0.13 (standard deviation) for complete response (n = 4), 2.36 ± 1.78 for stable disease (n = 41), 4.84 ± 3.32 for progressive disease (n = 130), and 3.82 ± 1.93 for death (n = 14). Kaplan-Meier estimates of median time to progression in days indicated that patients with a relative CBV of less than 1.75 had a median time to progression of 3585 days, whereas patients with a relative CBV of more than 1.75 had a time to progression of 265 days. Age and relative CBV were also independent predictors for clinical outcome. Conclusion: Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging can be used to predict median time to progression in patients with gliomas, independent of pathologic findings. Patients who have HGGs and LGGs with a high relative CBV (>1.75) have a significantly more rapid time to progression than do patients who have gliomas with a low relative CBV. © RSNA, 2008.
Keywords: adolescent; adult; cancer survival; child; controlled study; human tissue; preschool child; school child; aged; aged, 80 and over; child, preschool; middle aged; survival rate; retrospective studies; disease course; histopathology; area under the curve; nuclear magnetic resonance imaging; outcome assessment; brain tumor; follow up; glioma; methodology; brain neoplasms; magnetic resonance imaging; cancer susceptibility; demography; logistic models; risk factors; pathology; retrospective study; risk factor; diagnostic agent; disease progression; contrast enhancement; prediction and forecasting; predictive value of tests; contrast medium; contrast media; area under curve; tumor growth; gadolinium pentetate; gadolinium dtpa; blood volume; brain blood vessel; statistical model; cerebrovascular circulation; perfusion weighted imaging; brain circulation
Journal Title: Radiology
Volume: 247
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2008-05-01
Start Page: 490
End Page: 498
Language: English
DOI: 10.1148/radiol.2472070898
PUBMED: 18349315
PROVIDER: scopus
PMCID: PMC3774106
DOI/URL:
Notes: --- - "Cited By (since 1996): 61" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus"
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  1. Robert J Young
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