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Association of dynamic susceptibility contrast enhanced MR Perfusion parameters with prognosis in elderly patients with glioblastomas

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

We aimed to evaluate the prognostic value of dynamic susceptibility contrast (DSC) MR perfusion in elderly patients with glioblastomas (GBM).

Methods

Thirty five patients aged ≥65 and 35 aged <65 years old, (referred to as elderly and younger, respectively) were included in this retrospective study. The median relative cerebral volume (rCBV) from the enhancing region (rCBVER-Med) and immediate peritumoral region (rCBVIPR-Med) and maximum rCBV from the enhancing region of the tumor (rCBVER-Max) were compared and correlated with survival data. Analysis was repeated after rCBVs were dichotomized into high and low values and after excluding elderly patients who did not receive postoperative chemoradiation (34.3 %). Kaplan-Meyer survival curves and parametric and semi-parametric regression tests were used for analysis.

Results

All rCBV parameters were higher in elderly compared to younger patients (p < 0.05). After adjustment for age, none were independently associated with shorter survival (p > 0.05). After rCBV dichotomization into high and low values, high rCBV in elderly was independently associated with shorter survival compared to low rCBV in elderly, or any rCBV in younger patients (p < 0.05).

Conclusion

rCBV can be an imaging biomarker to identify a subgroup of GBM patients in the elderly with worse prognosis compared to others.

Key Points

• GBM perfusion parameters are higher in elderly compared to younger patients.

• rCBV can identify a subgroup of elderly patients with worse prognosis.

• rCBV can be an imaging biomarker for prognostication in GBM.

• The identified elderly patients may benefit from anti-angiogenic treatment.

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Abbreviations

rCBV:

Relative cerebral blood volume

rCBVER-Med :

Median rCBV in the enhancing region

rCBVIPR-Med :

Median rCBV in the immediate peritumoral region

rCBVER-Max :

Maximum rCBV in the enhancing region

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Acknowledgements

The scientific guarantor of this publication is Dr. Suyash Mohan. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Rahim Moineddin PhD, Research Services Unit, Dalla Lana School of Public Health, University of Toronto kindly provided statistical advice for this manuscript. Also Edward H. Herskovits, MD PhD, who is one of the authors, has significant statistical expertise and provided statistical advice. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. A subgroup of study subjects have been previously reported in the American Society of Neuroradiology meeting in San Diego in 2012. Methodology: retrospective, case-control study, performed at one institution.

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Authors and Affiliations

  1. Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

    Pejman Jabehdar Maralani

  2. Department of Radiology, University of Maryland Medical Center, 22 S. Greene St., Baltimore, MD, 21201, USA

    Elias R. Melhem & Edward H. Herskovits

  3. Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at University of Pennsylvania, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Sumei Wang, Matthew R. Voluck, Kim O. Learned & Suyash Mohan

  4. Department of Radiology, University of Ulsan Asan Medical Center, 388-1, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea

    Sang Joon Kim

  5. Department of Surgery, Division of Neurosurgery, Perelman School of Medicine at University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Donald M. O’Rourke

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  1. Pejman Jabehdar Maralani
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Correspondence to Suyash Mohan.

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Jabehdar Maralani, P., Melhem, E.R., Wang, S. et al. Association of dynamic susceptibility contrast enhanced MR Perfusion parameters with prognosis in elderly patients with glioblastomas. Eur Radiol 25, 2738–2744 (2015). https://doi.org/10.1007/s00330-015-3640-4

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  • DOI: https://doi.org/10.1007/s00330-015-3640-4

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