title: Prognostic Value of Dynamic Susceptibility Contrast-Enhanced and Diffusion-Weighted MR Imaging in Patients with Glioblastomas.
abstract: OBJECTIVE
  Prediction of survival in patients with glioblastomas is important for individualized treatment planning. This study aimed to assess the prognostic utility of presurgical dynamic susceptibility contrast and diffusion-weighted imaging for overall survival in patients with glioblastoma.
  
  
  METHODS
  MR imaging data from pathologically proved glioblastomas between June 2006 to December 2013 in 58 patients (mean age, 62.7 years; age range, 22-89 years) were included in this retrospective study. Patients were divided into long survival (≥15 months) and short survival (<15 months) groups, depending on overall survival time. Patients underwent dynamic susceptibility contrast perfusion and DWI before surgery and were treated with chemotherapy and radiation therapy. The maximum relative cerebral blood volume and minimum mean diffusivity values were measured from the enhancing part of the tumor.
  
  
  RESULTS
  Maximum relative cerebral blood volume values in patients with short survival were significantly higher compared with those who demonstrated long survival (P < .05). No significant difference was observed in the minimum mean diffusivity between short and long survivors. Receiver operator curve analysis demonstrated that a maximum relative cerebral blood volume cutoff value of 5.79 differentiated patients with low and high survival with an area under the curve of 0.93, sensitivity of 0.89, and specificity of 0.90 (P < .001), while a minimum mean diffusivity cutoff value of 8.35 × 10(-4)mm(2)/s had an area under the curve of 0.55, sensitivity of 0.71, and specificity of 0.47 (P > .05) in separating the 2 groups.
  
  
  CONCLUSIONS
  Maximum relative cerebral blood volume may be used as a prognostic marker of overall survival in patients with glioblastomas.
authors.affiliation: From the Department of Radiology (G.Ç., F.K.), Baskent University School of Medicine, Ankara, Turkey Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).
authors.forename: G
authors.identifier: http://orcid.org/0000-0002-4010-2883
authors.initials: G
authors.lastname: Çoban
authors.affiliation: Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).
authors.forename: S
authors.initials: S
authors.lastname: Mohan
authors.affiliation: From the Department of Radiology (G.Ç., F.K.), Baskent University School of Medicine, Ankara, Turkey Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).
authors.forename: F
authors.initials: F
authors.lastname: Kural
authors.affiliation: Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.affiliation: Neurosurgery (D.M.O.), University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: D M
authors.initials: DM
authors.lastname: O'Rourke
authors.affiliation: Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.) Harish.Poptani@liverpool.ac.uk.
authors.forename: H
authors.initials: H
authors.lastname: Poptani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001810:Blood Volume; D001811:Blood Volume Determination; D001932:Brain Neoplasms / Q000098:blood supply* / Q000401:mortality* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005909:Glioblastoma / Q000098:blood supply* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D055815:Young Adult
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