Journal
KOREAN JOURNAL OF RADIOLOGY
Volume 22, Issue 8, Pages 1369-1378Publisher
KOREAN RADIOLOGICAL SOC
DOI: 10.3348/kjr.2020.1272
Keywords
Glioblastoma multiforme; Dynamic contrast-enhanced MR imaging; Dynamic susceptibility contrast MR imaging; Prognosis prediction; Peritumoral area
Funding
- Korea Healthcare technology R&D Projects, Ministry for Health, Welfare Family Affairs [HI16C1111]
- National Research Foundation of Korea (NRF) - Ministry of Science, ICT & Future Planning [2016M3C7A1914002, 2020R1A2C2008949, NRF-2019K1A3A1A77079379]
- Seoul National University (SNU)
- Institute for Basic Science [IBS-R006-A1]
- National Research Foundation of Korea [2019K1A3A1A77079379, 2020R1A2C2008949] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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This study demonstrated the prognostic value of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM, with the 95th percentile value of Ktrans identified as an independent predictor of early progression.
Objective: Few attempts have been made to investigate the prognostic value of dynamic contrast-enhanced (DCE) MRI or dynamic susceptibility contrast (DSC) MRI of non-enhancing, T2-high-signal-intensity (T2-HSI) lesions of glioblastoma multiforme (GBM) in newly diagnosed patients. This study aimed to investigate the prognostic values of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM. Materials and Methods: A total of 76 patients with GBM who underwent preoperative DCE MRI and DSC MRI and standard treatment were retrospectively included. Six months after surgery, the patients were categorized into early progression (n = 15) and non-early progression (n = 61) groups. We extracted and analyzed the permeability and perfusion parameters of both modalities for the non-enhancing, T2-HSI lesions of the tumors. The optimal percentiles of the respective parameters obtained from cumulative histograms were determined using receiver operating characteristic (ROC) curve and univariable Cox regression analyses. The results were compared using multivariable Cox proportional hazards regression analysis of progression-free survival. Results: The 95th percentile value (PV) of Ktrans, mean Ktrans, and median Ve were significant predictors of early progression as identified by the ROC curve analysis (area under the ROC curve [AUC] = 0.704, p = 0.005; AUC = 0.684, p = 0.021; and AUC = 0.670, p = 0.0325, respectively). Univariable Cox regression analysis of the above three parametric values showed that the 95th PV of Ktrans and the mean Ktrans were significant predictors of early progression (hazard ratio [HR] = 1.06, p = 0.009; HR = 1.25, p = 0.017, respectively). Multivariable Cox regression analysis, which also incorporated clinical parameters, revealed that the 95th PV of Ktrans was the sole significant independent predictor of early progression (HR = 1.062, p < 0.009). Conclusion: The 95th PV of Ktrans from the non-enhancing, T2-HSI lesions of GBM is a potential prognostic marker for disease progression.
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