title: Arterial spin-labeling perfusion MRI stratifies progression-free survival and correlates with epidermal growth factor receptor status in glioblastoma.
abstract: OBJECTIVE
  Glioblastoma is a common primary brain tumor with a poor but variable prognosis. Our aim was to investigate the feasibility of MR perfusion imaging by using arterial spin-labeling for determining the prognosis of patients with glioblastoma.
  
  
  METHODS
  Pseudocontinuous arterial spin-labeling with 3D background-suppressed gradient and spin-echo was acquired before surgery on 53 patients subsequently diagnosed with glioblastoma. The calculated CBF color maps were visually evaluated by 3 independent readers blinded to patient history. Pathologic and survival data were correlated with CBF map findings. Arterial spin-labeling values in tumor tissue were also quantified by using manual fixed-size ROIs.
  
  
  RESULTS
  Two perfusion patterns were characterized by visual evaluation of CBF maps on the basis of either the presence (pattern 1) or absence (pattern 2) of substantial hyperperfused tumor tissue. Evaluation of the perfusion patterns was highly concordant among the 3 readers (κ = 0.898, P < .001). Pattern 1 (versus pattern 2) was associated with significantly shorter progression-free survival by Kaplan-Meier analysis (median progression-free survival of 182 days versus 485 days, P < .01) and trended with shorter overall survival (P = .079). There was a significant association between pattern 1 and epidermal growth factor receptor variant III expression (P < .01).
  
  
  CONCLUSIONS
  Qualitative evaluation of arterial spin-labeling CBF maps can be used to stratify survival and predict epidermal growth factor receptor variant III expression in patients with glioblastoma.
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: X J
authors.initials: XJ
authors.lastname: Qiao
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: B M
authors.initials: BM
authors.lastname: Ellingson
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
authors.forename: D J J
authors.initials: DJ
authors.lastname: Wang
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: N
authors.initials: N
authors.lastname: Salamon
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: M
authors.initials: M
authors.lastname: Linetsky
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: A R
authors.initials: AR
authors.lastname: Sepahdari
authors.affiliation: Department of Radiology (B.J.), Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: B
authors.initials: B
authors.lastname: Jiang
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: J J
authors.initials: JJ
authors.lastname: Tian
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.).
authors.forename: S R
authors.initials: SR
authors.lastname: Esswein
authors.affiliation: Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
authors.forename: T F
authors.initials: TF
authors.lastname: Cloughesy
authors.affiliation: Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
authors.forename: A
authors.initials: A
authors.lastname: Lai
authors.affiliation: Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
authors.forename: L
authors.initials: L
authors.lastname: Nghiemphu
authors.affiliation: From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.) wpope@mednet.ucla.edu.
authors.forename: W B
authors.initials: WB
authors.lastname: Pope
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D005909:Glioblastoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013113:Spin Labels
chemical_list: D013113:Spin Labels; C512478:EGFR protein, human; D066246:ErbB Receptors