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

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.

Prognostic value of preoperative dynamic contrast-enhanced MRI perfusion parameters for high-grade glioma patients

“…Nguyen et al [26] found both higher K trans and v p to be associated with worse OS in a population of mixed grade II–IV astrocytomas, oligoastrocytomas, and oligodendrogliomas, using the hot-spot ROI method. Bonekamp et al [10] found K trans to be independently associated with worse survival in a sample of 37 GBMs. Compared to DSC-calculated rCBV, K trans was associated with a remarkably higher hazard ratio.…”

“…DCE perfusion also enables calculation of other parameters such as extracellular volume fraction (v e ), reverse transfer rate (k ep ), vascular plasma volume fraction (v p ), and initial area under the gadolinium concentration time curve (IAUGC). These parameters provide additional information about physiological tumor properties and could afford independent insight about clinical tumor behavior, especially as DCE perfusion parameters were shown not to correlate with DSC [10] or diffusion parameters [11] closely. DCE perfusion parameters have already been demonstrated to be diagnostic for glioma grade [12–17] and correlate with several proxies of hypoxia like microvascular density [18, 19] and HIF-1α and vascular endothelial growth factor (VEGF) expression [20].…”

“…Thus far, research on the prognostic value of DCE perfusion for HGG patient survival has been scarce—only a few studies have been conducted [10, 20, 24–26], some of them presenting contradicting results [27], focusing mostly on K trans and v p , and some of them employing the hot-spot method, where only tumor regions with subjectively highest parameter values are analyzed. We set out to partially fill this knowledge gap with a larger study sample and a comprehensive whole tumor volume histogram analysis of more DCE-MRI pharmacokinetic modeling parameters.…”

Therapeutic options in recurrent glioblastoma—An update

“…Several imaging techniques and modalities have been proposed for the identification of response or progression as well as prognostic or predictive tools for therapeutic efficacy, e.g. perfusion imaging, dynamic susceptibility contrast, apparent diffusion coefficient and MR spectroscopy [12][13][14][15][16][17][18]. However, these studies are limited in patient size and/or adequate control groups.…”

MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives

“…Prognostic value of K trans has been particularly investigated, showing a correlation between high baseline levels and poor PFS and OS [58]. K trans and CBV, interestingly, did not co-correlate with prognosis.…”