Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 19, Issue 5, Pages 546-554Publisher
WILEY
DOI: 10.1002/jmri.20039
Keywords
glioblastoma multiforme; H-1 MRSI; diffusion-weighted MRI; perfusion-weighted MRI; survival
Funding
- NCI NIH HHS [R01 CA79719, K01 CA76998] Funding Source: Medline
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Purpose: To investigate the potential value of pre-external-beam radiation therapy (XRT) choline-to-NAA (N-acetylaspartate) index (CNI), apparent diffusion coefficient (ADC), and relative cerebral blood volume (rCBV) for predicting survival in newly diagnosed patients with glioblastoma multiforme (GBM). Materials and Methods: Twenty-eight patients with GBM were studied using in vivo proton magnetic resonance spectroscopic imaging (H-1 MRSI) and diffusion- and perfusion-weighted imaging after surgery but prior to XRT. Patients were categorized on the basis of their volumes of morphologic and metabolic abnormalities (volume of CNI : 2 and CNI values), normalized ADC (nADC), or rCBV values within the T1 contrast-enhancing and T2 regions. The median survival time was compared. Results: A significantly shorter median survival time was observed for patients with a large volume of metabolic abnormality than for those with a small abnormality (12.0 and 17.1 months, respectively, P = 0.002). A similar pattern was observed for patients with a low mean nADC value compared to those with high mean nADC value within the T2 region (11.2 and 21.7 months, respectively, P = 0.004). A shorter median survival time was also observed for patients with contrast-enhancing residual disease than for those without the presence of contrast enhancement with marginal significance. Conclusion: The pre-XRT volume of the metabolic abnormality and the nADC value within the T2 region may be valuable in predicting outcome for patients with GBM.
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