European Radiology

, Volume 27, Issue 8, pp 3156–3166 | Cite as

Dynamic contrast-enhanced MR imaging in predicting progression of enhancing lesions persisting after standard treatment in glioblastoma patients: a prospective study

  • Roh-Eul Yoo
  • Seung Hong Choi
  • Tae Min Kim
  • Chul-Kee Park
  • Sung-Hye Park
  • Jae-Kyung Won
  • Il Han Kim
  • Soon Tae Lee
  • Hye Jeong Choi
  • Sung-Hye You
  • Koung Mi Kang
  • Tae Jin Yun
  • Ji-Hoon Kim
  • Chul-Ho Sohn



To prospectively explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE–MRI) in predicting the progression of enhancing lesions persisting after standard treatment in patients with surgically resected glioblastoma (GBM).


Forty-seven GBM patients, who underwent near-total tumorectomy followed by concurrent chemoradiation therapy (CCRT) with temozolomide (TMZ) between May 2014 and February 2016, were enrolled. Twenty-four patients were finally analyzed for measurable enhancing lesions persisting after standard treatment. DCE-MRI parameters were calculated at enhancing lesions. Mann–Whitney U tests and multivariable stepwise logistic regression were used to compare parameters between progression (n = 16) and non-progression (n = 8) groups.


Mean Ktrans and ve were significantly lower in progression than in non-progression (P = 0.037 and P = 0.037, respectively). The 5th percentile of the cumulative Ktrans histogram was also significantly lower in the progression than in non-progression group (P = 0.017). Mean ve was the only independent predictor of progression (P = 0.007), with a sensitivity of 100%, specificity of 63%, and an overall accuracy of 88% at a cut-off value of 0.873.


DCE-MRI may help predict the progression of enhancing lesions persisting after the completion of standard treatment in patients with surgically resected GBM, with mean ve serving as an independent predictor of progression.

Key points

Enhancing lesions may persist after standard treatment in GBM patients.

DCE-MRI may help predict the progression of the enhancing lesions.

Mean Ktransand vewere lower in progression than in non-progression group.

DCE-MRI may help identify patients requiring close follow-up after standard treatment.

DCE-MRI may help plan treatment strategies for GBM patients.


Chemoradiotherapy Glioblastoma Magnetic resonance imaging Perfusion Progression 



Arterial input function


Blood–brain barrier


Cerebral blood volume


Concurrent radiation therapy and chemotherapy


Confidence interval


Dynamic contrast-enhanced




Fluid-attenuated inversion recovery sequence


Field of view




Interquartile range


O6-Methylguanine DNA methyltransferase


Magnetization-prepared rapid acquisition gradient echo


Number of excitations


Response assessment in neuro-oncology


Receiver operating characteristic


Region of interest


Echo time


Inversion time




Repetition time


T1-weighted imaging


T2-weighted imaging


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Roh-Eul Yoo
    • 1
  • Seung Hong Choi
    • 1
    • 2
    • 3
  • Tae Min Kim
    • 4
  • Chul-Kee Park
    • 5
  • Sung-Hye Park
    • 6
  • Jae-Kyung Won
    • 6
  • Il Han Kim
    • 7
  • Soon Tae Lee
    • 8
  • Hye Jeong Choi
    • 1
  • Sung-Hye You
    • 1
  • Koung Mi Kang
    • 1
  • Tae Jin Yun
    • 1
  • Ji-Hoon Kim
    • 1
  • Chul-Ho Sohn
    • 1
  1. 1.Department of RadiologySeoul National University College of MedicineSeoulKorea
  2. 2.Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological EngineeringSeoul National UniversitySeoulKorea
  3. 3.School of Chemical and Biological EngineeringSeoul National UniversitySeoulKorea
  4. 4.Department of Internal Medicine, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  5. 5.Department of Neurosurgery, Biomedical Research InstituteSeoul National University College of MedicineSeoulKorea
  6. 6.Department of PathologySeoul National University College of MedicineSeoulKorea
  7. 7.Department of Radiation Oncology, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  8. 8.Department of NeurologySeoul National University College of MedicineSeoulKorea

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