title: Prognostic value of blood flow measurements using arterial spin labeling in gliomas.
abstract: The period of event-free survival (EFS) within the same histopathological glioma grades may have high variability, mainly without a known cause. The purpose of this study was to reveal the prognostic value of quantified tumor blood flow (TBF) values obtained by arterial spin labeling (ASL) for EFS in patients with histopathologically proven astrocytomas independent of WHO (World Health Organization) grade. Twenty-four patients with untreated gliomas underwent tumor perfusion quantification by means of pulsed ASL in 3T. The clinical history of the patients was retrospectively extracted from the local database. Six patients had to be excluded due to insufficent follow-up data for further evaluation or histopathologically verified oligodendroglioma tumor components. Receiver operating characteristic (ROC) curves were used to define an optimal cut-off value of maximum TBF (mTBF) values for subgrouping in low-perfused and high-perfused gliomas. Kaplan-Meier curves and Cox proportional hazard regression model were used to determine the prognostic value of mTBF for EFS. An optimal mTBF cut-off value of 182 ml/100 g/min (sensitivity  = 83%, specificity  = 100%) was determined. Patients with low-perfused gliomas had significantly longer EFS compared to patients with high-perfused gliomas (p = 0.0012) independent of the WHO glioma grade. Quantified mTBF values obtained by ASL offer a new and totally non-invasive marker to prognosticate the EFS, independently on histopathological tumor grading, in patients with gliomas.
authors.affiliation: Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Furtner
authors.affiliation: Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bender
authors.affiliation: Department of Neurology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Braun
authors.affiliation: Department of Neuropathology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Schittenhelm
authors.affiliation: Department of Neurosurgery, Eberhard Karls University, Tübingen, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Skardelly
authors.affiliation: Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ernemann
authors.affiliation: Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Bisdas
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D012372:ROC Curve; D012039:Regional Blood Flow; D013113:Spin Labels
chemical_list: D013113:Spin Labels