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High-resolution blood-pool-contrast-enhanced MR angiography in glioblastoma: tumor-associated neovascularization as a biomarker for patient survival. A preliminary study

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

The objective of the study was to determine whether tumor-associated neovascularization on high-resolution gadofosveset-enhanced magnetic resonance angiography (MRA) is a useful biomarker for predicting survival in patients with newly diagnosed glioblastomas.

Methods

Before treatment, 35 patients (25 men; mean age, 64 ± 14 years) with glioblastoma underwent MRI including first-pass dynamic susceptibility contrast (DSC) perfusion and post-contrast T1WI sequences with gadobutrol (0.1 mmol/kg) and, 48 h later, high-resolution MRA with gadofosveset (0.03 mmol/kg). Volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter were obtained, and DSC perfusion and DWI parameters were evaluated. Prognostic factors were assessed by Kaplan-Meier survival and Cox proportional hazards model.

Results

Eighteen (51.42 %) glioblastomas were hypervascular on high-resolution MRA. Hypervascular glioblastomas were associated with higher CEL volume and lower Karnofsky score. Median survival rates for patients with hypovascular and hypervascular glioblastomas treated with surgery, radiotherapy, and chemotherapy were 15 and 9.75 months, respectively (P < 0.001). Tumor-associated neovascularization was the best predictor of survival at 5.25 months (AUC = 0.794, 81.2 % sensitivity, 77.8 % specificity, 76.5 % positive predictive value, 82.4 % negative predictive value) and yielded the highest hazard ratio (P < 0.001).

Conclusions

Tumor-associated neovascularization detected on high-resolution blood-pool-contrast-enhanced MRA of newly diagnosed glioblastoma seems to be a useful biomarker that correlates with worse survival.

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Author information

Authors and Affiliations

  1. Research Unit of Diagnostic Imaging Institute (IDI), Department of Radiology [Girona Biomedical Research Institute] IDIBGI, Hospital Universitari Dr Josep Trueta, Av de Francia s/n, 17007, Girona, Spain

    Josep Puig, Gerard Blasco, Sebastián Remollo, David Hernández & Salvador Pedraza

  2. Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain

    Josep Daunis-i-Estadella & Gloria Mateu

  3. Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, La Fe Polytechnics and University Hospital, Valencia, Spain

    Angel Alberich-Bayarri

  4. Department of Radiology, University of Manitoba, Winnipeg, Canada

    Marco Essig

  5. Division of Neuroradiology, Department of Radiology, NYU School of Medicine, New York, NY, USA

    Rajan Jain

  6. Catalan Institute of Oncology (ICO), Hospital Cancer Registry, Hospital Universitari Dr Josep Trueta, Girona, Spain

    Montserrat Puigdemont

  7. Philips Healthcare Ibérica, Madrid, Spain

    Javier Sánchez-González

  8. Department of Radiology, Neuroradiology Division, Stanford University, Palo Alto, CA, USA

    Max Wintermark

Authors
  1. Josep Puig
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  2. Gerard Blasco
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  3. Josep Daunis-i-Estadella
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  4. Angel Alberich-Bayarri
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  5. Marco Essig
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  6. Rajan Jain
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  7. Sebastián Remollo
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  8. David Hernández
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  9. Montserrat Puigdemont
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  10. Javier Sánchez-González
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  11. Gloria Mateu
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  12. Max Wintermark
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  13. Salvador Pedraza
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Corresponding author

Correspondence to Josep Puig.

Ethics declarations

Ethical standards and patient consent

We declare that all human studies have been approved by the local Ethics Committee of Hospital Universitari Dr Josep Trueta in Girona and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

The authors declare that they have no competing interests.

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Puig, J., Blasco, G., Daunis-i-Estadella, J. et al. High-resolution blood-pool-contrast-enhanced MR angiography in glioblastoma: tumor-associated neovascularization as a biomarker for patient survival. A preliminary study. Neuroradiology 58, 17–26 (2016). https://doi.org/10.1007/s00234-015-1599-0

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  • DOI: https://doi.org/10.1007/s00234-015-1599-0

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