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RT Journal Article
SR Electronic
T1 Dynamic Contrast-Enhanced MR Imaging of Nonenhancing T2 High-Signal-Intensity Lesions in Baseline and Posttreatment Glioblastoma: Temporal Change and Prognostic Value
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 49
OP 56
DO 10.3174/ajnr.A6323
VO 41
IS 1
A1 Hwang, I.
A1 Choi, S.H.
A1 Park, C.-K.
A1 Kim, T.M.
A1 Park, S.-H.
A1 Won, J.K.
A1 Kim, I.H.
A1 Lee, S.-T.
A1 Yoo, R.-E.
A1 Kang, K.M.
A1 Yun, T.J.
A1 Kim, J.-H.
A1 Sohn, C.-H.
YR 2020
UL http://www.ajnr.org/content/41/1/49.abstract
AB BACKGROUND AND PURPOSE: The prognostic value of dynamic contrast-enhanced MR imaging on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma has not been thoroughly elucidated to date. We evaluated the temporal change and prognostic value for progression-free survival of dynamic contrast-enhanced MR imaging–derived pharmacokinetic parameters on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma before and after standard treatment, including gross total surgical resection.MATERIALS AND METHODS: This retrospective study included 33 patients who were newly diagnosed with glioblastoma and treated with gross total surgical resection followed by concurrent chemoradiation therapy and adjuvant chemotherapy with temozolomide in a single institution. All patients underwent dynamic contrast-enhanced MR imaging before surgery as a baseline and after completion of maximal surgical resection and concurrent chemoradiation therapy. On the whole nonenhancing T2 high-signal-intensity lesion, dynamic contrast-enhanced MR imaging–derived pharmacokinetic parameters (volume transfer constant [Ktrans], volume of extravascular extracellular space [ve], and blood plasma volume [vp]) were calculated. The Cox proportional hazards regression model analysis was performed to determine the histogram features or percentage changes of pharmacokinetic parameters related to progression-free survival.RESULTS: Baseline median Ktrans, baseline first quartile Ktrans, and posttreatment median Ktrans were significant independent variables, as determined by univariate analysis (P &lt; .05). By multivariate Cox regression analysis including methylation status of O6-methylguanine-DNA methyltransferase, baseline median Ktrans was determined to be the significant independent variable and was negatively related to progression-free survival (hazard ratio = 1.48, P = .003).CONCLUSIONS: Baseline median Ktrans from nonenhancing T2 high-signal-intensity lesions could be a potential prognostic imaging biomarker in patients undergoing gross total surgical resection followed by standard therapy for glioblastoma.CCRTconcurrent chemoradiation therapyDCEdynamic contrast-enhancedKtransvolume transfer constantMGMTO6-methylguanine-DNA methyltransferasePFSprogression-free survivalTMZtemozolomidevevolume of extravascular extracellular spacevpblood plasma volume