title: Survival analysis in patients with newly diagnosed glioblastoma using pre- and postradiotherapy MR spectroscopic imaging.
abstract: BACKGROUND
  The objective of this study was to examine the predictive value of parameters of 3D (1)H magnetic resonance spectroscopic imaging (MRSI) prior to treatment with radiation/chemotherapy (baseline) and at a postradiation 2-month follow-up (F2mo) in relationship to 6-month progression-free survival (PFS6) and overall survival (OS).
  
  
  METHODS
  Sixty-four patients with newly diagnosed glioblastoma multiforme (GBM) being treated with radiation and concurrent chemotherapy were involved in this study. Evaluated were metabolite indices and metabolite ratios. Logistic linear regression and Cox proportional hazards models were utilized to evaluate PFS6 and OS, respectively. These analyses were adjusted by age and MR scanner field strength (1.5 T or 3 T). Stepwise regression was performed to determine a subset of the most relevant variables.
  
  
  RESULTS
  Associated with shorter PFS6 were a decrease in the ratio of N-acetyl aspartate to choline-containing compounds (NAA/Cho) in the region with a Cho-to-NAA index (CNI) >3 at baseline and an increase of the CNI within elevated CNI regions (>2) at F2mo. Patients with higher normalized lipid and lactate at either time point had significantly worse OS. Patients who had larger volumes with abnormal CNI at F2mo had worse PFS6 and OS.
  
  
  CONCLUSIONS
  Our study found more 3D MRSI parameters that predicted PFS6 and OS for patients with GBM than did anatomic, diffusion, or perfusion imaging, which were previously evaluated in the same population of patients.
authors: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA. yan.li@ucsf.edu
authors: Yan
authors: Y
authors: Li
authors: Janine M
authors: JM
authors: Lupo
authors: Rupa
authors: R
authors: Parvataneni
authors: Kathleen R
authors: KR
authors: Lamborn
authors: Soonmee
authors: S
authors: Cha
authors: Susan M
authors: SM
authors: Chang
authors: Sarah J
authors: SJ
authors: Nelson
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D059248:Chemoradiotherapy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor
references: Neuroradiology. 2008 Sep;50(9):759-67
references: 18523762
references: J Neurosurg. 2003 Feb;98(2):269-76
references: 12593610
references: J Magn Reson Imaging. 2004 May;19(5):546-54
references: 15112303
references: Cancer. 2008 Jul 15;113(2):405-10
references: 18484594
references: Cancer Radiother. 2009 Oct;13(6-7):556-61
references: 19766525
references: Neurosurgery. 2003 Sep;53(3):565-74; discussion 574-6
references: 12943573
references: J Neurooncol. 1997 May;32(3):253-65
references: 9049887
references: Anticancer Res. 2011 Oct;31(10):3559-65
references: 21965778
references: Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):381-9
references: 17513061
references: J Neurosurg. 2002 Oct;97(4):794-802
references: 12405365
references: NMR Biomed. 2006 Jun;19(4):463-75
references: 16763973
references: Int J Radiat Oncol Biol Phys. 1998 Jan 15;40(2):279-86
references: 9457810
references: J Magn Reson Imaging. 2001 Feb;13(2):167-77
references: 11169821
references: J Magn Reson Imaging. 2002 Sep;16(3):229-37
references: 12205577
references: J Clin Oncol. 2010 Apr 10;28(11):1963-72
references: 20231676
references: Ann Biomed Eng. 2011 Jan;39(1):193-204
references: 20652745
references: Acta Neurol Scand. 1998 Jan;97(1):52-62
references: 9482679
references: J Neurooncol. 2009 Feb;91(3):337-51
references: 19009235
references: Magn Reson Imaging. 2006 Dec;24(10):1295-302
references: 17145400
references: Neuro Oncol. 2011 May;13(5):546-57
references: 21297128
references: IEEE Trans Med Imaging. 2001 Jan;20(1):45-57
references: 11293691
references: Q J Nucl Med Mol Imaging. 2009 Dec;53(6):618-30
references: 20016453
references: Cancer Res. 1997 Sep 1;57(17):3860-4
references: 9288800
references: AJNR Am J Neuroradiol. 2003 May;24(5):942-5
references: 12748098
references: J Clin Oncol. 1990 Jul;8(7):1277-80
references: 2358840
references: J Magn Reson Imaging. 2002 Oct;16(4):464-76
references: 12353260
references: Magn Reson Med. 2000 Jan;43(1):23-33
references: 10642728
references: J Neurosci. 1993 Mar;13(3):981-9
references: 8441018
references: Neuro Oncol. 2010 Mar;12(3):274-82
references: 20167815
references: J Neurooncol. 2009 Jan;91(1):69-81
references: 18810326
references: Neuro Oncol. 2005 Apr;7(2):189-95
references: 15831237
references: Magn Reson Med. 2001 Aug;46(2):228-39
references: 11477625
references: J Magn Reson. 1998 Aug;133(2):243-54
references: 9716465
references: BioDrugs. 2009;23(5):289-304
references: 19754219
references: J Magn Reson Imaging. 1994 Nov-Dec;4(6):877-83
references: 7865950
references: J Magn Reson Imaging. 2009 Feb;29(2):291-7
references: 19161192
references: AJNR Am J Neuroradiol. 2003 Nov-Dec;24(10):1989-98
references: 14625221
references: N Engl J Med. 2005 Mar 10;352(10):987-96
references: 15758009
references: J Neurochem. 1998 Feb;70(2):835-40
references: 9453580
references: AJNR Am J Neuroradiol. 2005 Apr;26(4):760-9
references: 15814918
references: Expert Rev Anticancer Ther. 2009 May;9(5):613-9
references: 19445578
references: J Neurooncol. 2009 May;92(3):401-15
references: 19357966