title: Dynamic contrast-enhanced MR imaging in predicting progression of enhancing lesions persisting after standard treatment in glioblastoma patients: a prospective study.
abstract: OBJECTIVE
  To prospectively explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the progression of enhancing lesions persisting after standard treatment in patients with surgically resected glioblastoma (GBM).
  
  
  METHODS
  Forty-seven GBM patients, who underwent near-total tumorectomy followed by concurrent chemoradiation therapy (CCRT) with temozolomide (TMZ) between May 2014 and February 2016, were enrolled. Twenty-four patients were finally analyzed for measurable enhancing lesions persisting after standard treatment. DCE-MRI parameters were calculated at enhancing lesions. Mann-Whitney U tests and multivariable stepwise logistic regression were used to compare parameters between progression (n = 16) and non-progression (n = 8) groups.
  
  
  RESULTS
  Mean Ktransand vewere significantly lower in progression than in non-progression (P = 0.037 and P = 0.037, respectively). The 5th percentile of the cumulative Ktranshistogram was also significantly lower in the progression than in non-progression group (P = 0.017). Mean vewas the only independent predictor of progression (P = 0.007), with a sensitivity of 100%, specificity of 63%, and an overall accuracy of 88% at a cut-off value of 0.873.
  
  
  CONCLUSIONS
  DCE-MRI may help predict the progression of enhancing lesions persisting after the completion of standard treatment in patients with surgically resected GBM, with mean veserving as an independent predictor of progression.
  
  
  CONCLUSIONS
  • Enhancing lesions may persist after standard treatment in GBM patients. • DCE-MRI may help predict the progression of the enhancing lesions. • Mean Ktransand vewere lower in progression than in non-progression group. • DCE-MRI may help identify patients requiring close follow-up after standard treatment. • DCE-MRI may help plan treatment strategies for GBM patients.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Roh-Eul
authors.initials: RE
authors.lastname: Yoo
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea. verocay@snuh.org.|Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological Engineering, Seoul National University, 151-742, Seoul, Korea. verocay@snuh.org.|School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea. verocay@snuh.org.
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Tae Min
authors.initials: TM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chul-Kee
authors.initials: CK
authors.lastname: Park
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sung-Hye
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae-Kyung
authors.initials: JK
authors.lastname: Won
authors.affiliation: Department of Radiation Oncology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Il Han
authors.initials: IH
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Soon Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Hye Jeong
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Sung-Hye
authors.initials: SH
authors.lastname: You
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Koung Mi
authors.initials: KM
authors.lastname: Kang
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, 110-744, Seoul, Korea.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Chemoradiotherapy; Glioblastoma; Magnetic resonance imaging; Perfusion; Progression