Post-treatment changes of tumour perfusion parameters can help to predict survival in patients with high-grade astrocytoma.

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 astroc...

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Published in:European Radiology Vol. 27; no. 8; pp. 3392 - 3401
Main Authors: Sanz-Requena, Roberto, Revert-Ventura, Antonio, García-Martí, Gracián, Salamé-Gamarra, Fares, Pérez-Girbés, Alexandre, Mollá-Olmos, Enrique, Martí-Bonmatí, Luis, Revert-Ventura, Antonio J
Format: Journal Article
Published: Springer Nature Aug2017
Online Access:View this record in EBSCOhost
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      dt: Aug2017
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      pub: Springer Nature
      place: New York, New York
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        atl: Post-treatment changes of tumour perfusion parameters can help to predict survival in patients with high-grade astrocytoma.
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          Sanz-Requena, Roberto
          Revert-Ventura, Antonio
          García-Martí, Gracián
          Salamé-Gamarra, Fares
          Pérez-Girbés, Alexandre
          Mollá-Olmos, Enrique
          Martí-Bonmatí, Luis
          Revert-Ventura, Antonio J
        affil: Radiology Department , Hospital de Manises , Av Generalitat Valenciana 50 46940 Manises Spain
      sug:
        subj:
          Brain Neoplasms
          Neovascularization, Pathologic
          Glioma
          Combined Modality Therapy
          Glioma Blood Supply
          Female
          Aged
          Brain Neoplasms Blood Supply
          Prognosis
          Magnetic Resonance Imaging Methods
          Glioma Therapy
          Male
          Brain Neoplasms Pathology
          Brain Neoplasms Therapy
          Perfusion
          Glioma Pathology
          Retrospective Design
          Kaplan-Meier Estimator
          Cerebrovascular Circulation
          Neoplasm Grading
          Adult
          Middle Age
          Scales
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: 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), Ktrans-T2*, kep-T2*, ve-T2* and vp-T2* 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). Ktrans-T2* 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 Ktrans-T2* 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 trans-T2 values are predictive factors of OS. • Increased values may justify treatment intensification in these patients.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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