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
ISSN: 09387994





EUROPEAN RADIOLOGY
Editorial
SPRINGER, 233 SPRING ST, NEW YORK, NY 10013 USA, Alemania
Tipo de documento: Article
Volumen: 27 Número: 8
Páginas: 3392-3400
WOS Id: 000404655200032
ID de PubMed: 27999986
imagen Open Access

FULL TEXT

imagen Published Version CC BY

MÉTRICAS