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<meta name="DC.Title" content="Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1465" />
<meta name="DC.Date" content="2009-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Current classification and grading of primary brain tumors has significant limitations. Our aim was to determine whether the relative cerebral volume (rCBV) measurements in gliomas may serve as an adjunct to histopathologic grading, with a hypothesis that rCBV values are more accurate in predicting 1-year survival and recurrence.

MATERIALS AND METHODS: Thirty-four patients with gliomas (WHO grade I-IV, 27 astrocytomas, 7 tumors with oligodendroglial components) underwent contrast-enhanced MR rCBV measurements before treatment. The region of interest and the single pixel with the maximum CBV value within the tumors were normalized relative to the contralateral normal tissue (rCBVmean and rCBVmax, respectively). Karnofsky performance score and progression-free survival (PFS) were recorded. Receiver operating characteristic curves and Kaplan-Meier survival analysis were conducted for CBV and histologic grade (WHO grade).

RESULTS: Significant correlations were detected only when patients with oligodendrogliomas and oligoastrocytomas were excluded. The rCBVmean and rCBVmax in the astrocytomas were 3.5 ± 2.9 and 3.7 ± 2.7. PFS correlated with rCBV parameters ( r = −0.54 to −0.56, P ≤ .009). WHO grade correlated with rCBV values ( r = 0.65, P ≤ .0002). rCBVmax &gt;4.2 was found to be a significant cutoff value for recurrence prediction with 77.8% sensitivity and 94.4% specificity ( P = .0001). rCBVmax ≤3.8 was a significant predictor for 1-year survival (93.7% sensitivity, 72.7% specificity, P = .0002). The relative risk for shorter PFS was 11.1 times higher for rCBVmax &gt;4.2 ( P = .0006) and 6.7 times higher for WHO grade &gt;II ( P = .05). The combined CBV−WHO grade classification enhanced the predictive value for recurrence/progression ( P &lt; .0001).

CONCLUSIONS: rCBV values in astrocytomas but not tumors with oligodendroglial components are predictive for recurrence and 1-year survival and may be more accurate than histopathologic grading." />
<meta name="DC.Contributor" content="S. Bisdas" />
<meta name="DC.Contributor" content="M. Kirkpatrick" />
<meta name="DC.Contributor" content="P. Giglio" />
<meta name="DC.Contributor" content="C. Welsh" />
<meta name="DC.Contributor" content="M.V. Spampinato" />
<meta name="DC.Contributor" content="Z. Rumboldt" />
<meta name="article:published_time" content="2009-04-01" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Current classification and grading of primary brain tumors has significant limitations. Our aim was to determine whether the relative cerebral volume (rCBV) measurements in gliomas may serve as an adjunct to histopathologic grading, with a hypothesis that rCBV values are more accurate in predicting 1-year survival and recurrence.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; Thirty-four patients with gliomas (WHO grade I-IV, 27 astrocytomas, 7 tumors with oligodendroglial components) underwent contrast-enhanced MR rCBV measurements before treatment. The region of interest and the single pixel with the maximum CBV value within the tumors were normalized relative to the contralateral normal tissue (rCBV&lt;sub&gt;mean&lt;/sub&gt; and rCBV&lt;sub&gt;max&lt;/sub&gt;, respectively). Karnofsky performance score and progression-free survival (PFS) were recorded. Receiver operating characteristic curves and Kaplan-Meier survival analysis were conducted for CBV and histologic grade (WHO grade).&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Significant correlations were detected only when patients with oligodendrogliomas and oligoastrocytomas were excluded. The rCBV&lt;sub&gt;mean&lt;/sub&gt; and rCBV&lt;sub&gt;max&lt;/sub&gt; in the astrocytomas were 3.5 ± 2.9 and 3.7 ± 2.7. PFS correlated with rCBV parameters (&lt;i&gt;r&lt;/i&gt; = −0.54 to −0.56, &lt;i&gt;P&lt;/i&gt; ≤ .009). WHO grade correlated with rCBV values (&lt;i&gt;r&lt;/i&gt; = 0.65, &lt;i&gt;P&lt;/i&gt; ≤ .0002). rCBV&lt;sub&gt;max&lt;/sub&gt; &amp;gt;4.2 was found to be a significant cutoff value for recurrence prediction with 77.8% sensitivity and 94.4% specificity (&lt;i&gt;P&lt;/i&gt; = .0001). rCBV&lt;sub&gt;max&lt;/sub&gt; ≤3.8 was a significant predictor for 1-year survival (93.7% sensitivity, 72.7% specificity, &lt;i&gt;P&lt;/i&gt; = .0002). The relative risk for shorter PFS was 11.1 times higher for rCBV&lt;sub&gt;max&lt;/sub&gt; &amp;gt;4.2 (&lt;i&gt;P&lt;/i&gt; = .0006) and 6.7 times higher for WHO grade &amp;gt;II (&lt;i&gt;P&lt;/i&gt; = .05). The combined CBV−WHO grade classification enhanced the predictive value for recurrence/progression (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001).&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; rCBV values in astrocytomas but not tumors with oligodendroglial components are predictive for recurrence and 1-year survival and may be more accurate than histopathologic grading.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="S. Bisdas" />
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<meta name="citation_reference" content="citation_title=New England Journal of Medicine;citation_journal_abbrev=NEJM;citation_title=Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma;citation_pages=987-996;citation_volume=352;citation_year=2005;citation_issue=10;citation_issn=0028-4793;citation_pmid=15758009;citation_doi=10.1056/NEJMoa043330" />
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<meta name="twitter:title" content="Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Current classification and grading of primary brain tumors has significant limitations. Our aim was to determine whether the relative cerebral volume (rCBV) measurements in gliomas may serve as an adjunct to histopathologic grading, with a hypothesis that rCBV values are more accurate in predicting 1-year survival and recurrence.

MATERIALS AND METHODS: Thirty-four patients with gliomas (WHO grade I-IV, 27 astrocytomas, 7 tumors with oligodendroglial components) underwent contrast-enhanced MR rCBV measurements before treatment. The region of interest and the single pixel with the maximum CBV value within the tumors were normalized relative to the contralateral normal tissue (rCBVmean and rCBVmax, respectively). Karnofsky performance score and progression-free survival (PFS) were recorded. Receiver operating characteristic curves and Kaplan-Meier survival analysis were conducted for CBV and histologic grade (WHO grade).

RESULTS: Significant correlations were detected only when patients with oligodendrogliomas and oligoastrocytomas were excluded. The rCBVmean and rCBVmax in the astrocytomas were 3.5 ± 2.9 and 3.7 ± 2.7. PFS correlated with rCBV parameters ( r = −0.54 to −0.56, P ≤ .009). WHO grade correlated with rCBV values ( r = 0.65, P ≤ .0002). rCBVmax &gt;4.2 was found to be a significant cutoff value for recurrence prediction with 77.8% sensitivity and 94.4% specificity ( P = .0001). rCBVmax ≤3.8 was a significant predictor for 1-year survival (93.7% sensitivity, 72.7% specificity, P = .0002). The relative risk for shorter PFS was 11.1 times higher for rCBVmax &gt;4.2 ( P = .0006) and 6.7 times higher for WHO grade &gt;II ( P = .05). The combined CBV−WHO grade classification enhanced the predictive value for recurrence/progression ( P &lt; .0001).

CONCLUSIONS: rCBV values in astrocytomas but not tumors with oligodendroglial components are predictive for recurrence and 1-year survival and may be more accurate than histopathologic grading." />
<meta name="og-title" property="og:title" content="Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Current classification and grading of primary brain tumors has significant limitations. Our aim was to determine whether the relative cerebral volume (rCBV) measurements in gliomas may serve as an adjunct to histopathologic grading, with a hypothesis that rCBV values are more accurate in predicting 1-year survival and recurrence.

MATERIALS AND METHODS: Thirty-four patients with gliomas (WHO grade I-IV, 27 astrocytomas, 7 tumors with oligodendroglial components) underwent contrast-enhanced MR rCBV measurements before treatment. The region of interest and the single pixel with the maximum CBV value within the tumors were normalized relative to the contralateral normal tissue (rCBVmean and rCBVmax, respectively). Karnofsky performance score and progression-free survival (PFS) were recorded. Receiver operating characteristic curves and Kaplan-Meier survival analysis were conducted for CBV and histologic grade (WHO grade).

RESULTS: Significant correlations were detected only when patients with oligodendrogliomas and oligoastrocytomas were excluded. The rCBVmean and rCBVmax in the astrocytomas were 3.5 ± 2.9 and 3.7 ± 2.7. PFS correlated with rCBV parameters ( r = −0.54 to −0.56, P ≤ .009). WHO grade correlated with rCBV values ( r = 0.65, P ≤ .0002). rCBVmax &gt;4.2 was found to be a significant cutoff value for recurrence prediction with 77.8% sensitivity and 94.4% specificity ( P = .0001). rCBVmax ≤3.8 was a significant predictor for 1-year survival (93.7% sensitivity, 72.7% specificity, P = .0002). The relative risk for shorter PFS was 11.1 times higher for rCBVmax &gt;4.2 ( P = .0006) and 6.7 times higher for WHO grade &gt;II ( P = .05). The combined CBV−WHO grade classification enhanced the predictive value for recurrence/progression ( P &lt; .0001).

CONCLUSIONS: rCBV values in astrocytomas but not tumors with oligodendroglial components are predictive for recurrence and 1-year survival and may be more accurate than histopathologic grading." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node7691--5" data-node-nid="7691" id="top-node-7691--61110240773" data-pisa="ajnr;30/4/681" data-pisa-master="ajnr;ajnr.A1465" data-apath="/ajnr/30/4/681.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Bisdas</span>, <span class="highwire-citation-author" data-delta="1">M. Kirkpatrick</span>, <span class="highwire-citation-author" data-delta="2">P. Giglio</span>, <span class="highwire-citation-author" data-delta="3">C. Welsh</span>, <span class="highwire-citation-author" data-delta="4">M.V. Spampinato</span> and <span class="highwire-citation-author" data-delta="5">Z. Rumboldt</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2009,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">681-688; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1465 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-7691--61110240773" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Bisdas </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BBisdas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bisdas%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BBisdas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. 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Spampinato </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.V.%2BSpampinato%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Spampinato%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.V.%2BSpampinato%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Z. 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      <div class="highwire-cite-title">Cerebral Blood Volume Measurements by Perfusion-Weighted MR Imaging in Gliomas: Ready for Prime Time in Predicting Short-Term Outcome and Recurrent Disease?</div>  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Bisdas</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Kirkpatrick</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Giglio</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Welsh</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.V.</span> <span class="nlm-surname">Spampinato</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Rumboldt</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Apr 2009, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">681-688; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1465 </span></div>
  
  
  
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