Post-treatment changes of tumour perfusion parameters can help to predict survival in patients with high-grade astrocytoma
Por:
Sanz-Requena R, Revert-Ventura AJ, García-Martí G, Salamé-Gamarra F, Pérez-Girbés A, Mollá-Olmos E and Martí-Bonmatí L
Publicada:
1 ago 2017
Ahead of Print:
20 dic 2016
Resumen:
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.
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*, k(ep-T2*), v(e-T2*) and
v(p-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.
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.
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.
aEuro cent Vascular characteristics of high-grade glioma tumour and
peritumoral regions change with treatment.
aEuro cent Quantitative assessment of MRI perfusion provides valuable
information regarding tumour aggressiveness.
aEuro cent Quantitative T2*-weighted perfusion parameters can help to
predict overall survival.
aEuro cent aEuroePost-treatment variations of CBV and K (trans-T2)
values are predictive factors of OS.
aEuro cent Increased values may justify treatment intensification in
these patients.
Filiaciones:
Sanz-Requena R:
Radiology Department, Hospital Quirónsalud Valencia, Av Blasco Ibañez 14, 46010, Valencia, Spain.
Grupo de Investigación Biomédica en Imagen, Hospital Universitari i Politècnic La Fe, Av Fernando Abril Martorell 106, 46026, Valencia, Spain.
Revert-Ventura AJ:
Radiology Department, Hospital de Manises, Av Generalitat Valenciana 50, 46940, Manises, Spain
García-Martí G:
Radiology Department, Hospital Quirónsalud Valencia, Av Blasco Ibañez 14, 46010, Valencia, Spain
Grupo de Investigación Biomédica en Imagen, Hospital Universitari i Politècnic La Fe, Av Fernando Abril Martorell 106, 46026, Valencia, Spain
CIBER-SAM, Instituto de Salud Carlos III, C Doctor Esquerdo 46, 28007, Madrid, Spain
Salamé-Gamarra F:
Radiology Department, Hospital de Manises, Av Generalitat Valenciana 50, 46940, Manises, Spain
Pérez-Girbés A:
Grupo de Investigación Biomédica en Imagen, Hospital Universitari i Politècnic La Fe, Av Fernando Abril Martorell 106, 46026, Valencia, Spain
:
Radiology Department, Hospital La Ribera, Carretera de Corbera km 1, 46600, Alzira, Spain
Martí-Bonmatí L:
Radiology Department, Hospital Quirónsalud Valencia, Av Blasco Ibañez 14, 46010, Valencia, Spain
Grupo de Investigación Biomédica en Imagen, Hospital Universitari i Politècnic La Fe, Av Fernando Abril Martorell 106, 46026, Valencia, Spain
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