title: Association of overall survival in patients with newly diagnosed glioblastoma with contrast-enhanced perfusion MRI: Comparison of intraindividually matched T1 - and T2 (*) -based bolus techniques.
abstract: BACKGROUND
  To compare intraindividual dynamic susceptibility contrast (DSC) and dynamic contrast enhanced (DCE) MR perfusion parameters and determine the association of DCE parameters with overall survival (OS) with the established predictive DSC parameter cerebral blood volume (CBV) in patients with newly diagnosed glioblastoma.
  
  
  METHODS
  Perfusion data were analyzed retrospectively, and included scans performed preoperatively at 3.0 Tesla in 37 patients (25 males, 12 females, 39-83 years, median 65) later diagnosed with glioblastoma. All patients received standard treatment consisting of surgery and radiochemotherapy. Images were spatially coregistered and maximum region of interest-based DCE and DSC parameter measurements compared and thresholds identified using multivariate linear regression, Pearson's correlation coefficients and using receiver operating characteristic analysis. Survival analysis was performed using Kaplan-Meier curves.
  
  
  RESULTS
  While both, elevated volume transfer constant (K(trans) ) (>0.29 min(-1) ; P = 0.041) and CBV (>23.7 mL/100 mL; P < 0.001) were significantly associated with OS, elevated CBV was associated with worse OS compared with elevated K(trans) . K(trans) was significantly correlated with the leakage correction factor K2 but not with CBV.
  
  
  CONCLUSIONS
  The combined use of DSC and DCE MR perfusion may provide additional information of prognostic value for glioblastoma patient survival prediction. As K(trans) was not tightly coupled to CBV, both parameters may reflect different stages in the pathogenetic sequence of glioblastoma growth.
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, Germany.|Division of Experimental Radiology, Department of Neuroradiology, University Hospital Heidelberg, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Bonekamp
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, Germany.
authors.forename: Katerina
authors.initials: K
authors.lastname: Deike
authors.affiliation: Department of Neurooncology, University Hospital Heidelberg, Germany.|German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Wiestler
authors.affiliation: Department of Neurooncology, University Hospital Heidelberg, Germany.|German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bendszus
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, Germany.|German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Radbruch
authors.affiliation: Division of Experimental Radiology, Department of Neuroradiology, University Hospital Heidelberg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Heiland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D003198:Computer Simulation; D003287:Contrast Media; D005260:Female; D005858:Germany / Q000453:epidemiology; D005909:Glioblastoma / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000706:statistics & numerical data; D015994:Incidence; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D008954:Models, Biological; D009942:Organometallic Compounds; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016019:Survival Analysis
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
keywords: cerebral blood volume; dynamic contrast enhanced MRI; dynamic susceptibility contrast MRI; glioblastoma; magnetic resonance imaging; overall survival; perfusion imaging; volume transfer constant