title: Correlation between progression free survival and dynamic susceptibility contrast MRI perfusion in WHO grade III glioma subtypes.
abstract: The purpose of this study was to determine whether dynamic susceptibility contrast MR perfusion relative cerebral blood volume (rCBV) correlates with prognosis of World Health Organization (WHO) grade III glial tumors and their different subtypes. Retrospective evaluation of pre-treatment tumor rCBV derived from dynamic susceptibility contrast MR perfusion was performed in 34 patients with histopathologically diagnosed WHO grade III glial tumors (anaplastic astrocytomas (n = 20), oligodendrogliomas (n = 4), and oligoastrocytomas (n = 10)). Progression free survival was correlated with rCBV using Spearman rank analysis. ROC curve analysis was performed to determine the operating point for rCBV in patients with anaplastic astrocytomas dichotomized at the median progression free survival time. For all grade III tumors (n = 34) the mean rCBV was 2.51 with a progression free survival of 705.5 days. The mean rCBV of anaplastic astrocytomas was 2.47 with progression free survival 495.2 days. In contrast, the mean rCBV for oligodendroglial tumors was 2.56 with a progression free survival of 1005.6 days. Although there was no significant correlation between rCBV and progression free survival among all types of grade III gliomas (P = 0.12), among anaplastic astrocytomas there was a significant correlation between pretreatment rCBV and progression free survival with correlation coefficient of -0.51 (P = 0.02). The operating point for rCBV in patients with anaplastic astrocytomas dichotomized at the median progression free survival time (446.5 days) was 2.86 with 78 % accuracy and there was a significant difference between the survival of patients with anaplastic astrocytomas in the dichotomized groups (P = 0.0009). Pre-treatment rCBV may serve as a prognostic imaging biomarker for anaplastic astrocytomas, but not grade III oligodendroglioma tumors.
authors.affiliation: Department of Imaging Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mangla
authors.forename: Daniel Thomas
authors.initials: DT
authors.lastname: Ginat
authors.forename: Shervin
authors.initials: S
authors.lastname: Kamalian
authors.forename: Michael T
authors.initials: MT
authors.lastname: Milano
authors.forename: David N
authors.initials: DN
authors.lastname: Korones
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Walter
authors.forename: Sven
authors.initials: S
authors.lastname: Ekholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000401:mortality; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000098:blood supply / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult