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

Ulytė, Agnė; Katsaros, Vasileios K.; Liouta, Evangelia; Stranjalis, Georgios; Boskos, Christos; Papanikolaou, Nikolaos; Ušinskienė, Jurgita; Bisdas, Sotirios

doi:10.1007/s00234-016-1741-7

Cited by 49 publications

(50 citation statements)

References 55 publications

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“…This correlation might indicate that GBM aggressiveness is associated with a high angiogenic capacity. These results are consistent with the consideration of perfusion markers among the most consistently recognized independent predictors of survival and glioma grade progression …”

Section: Introductionsupporting

confidence: 86%

Improving the estimation of prognosis for glioblastoma patients by MR based hemodynamic tissue signatures

et al. 2018

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Advanced MRI and molecular markers have been raised as crucial to improve prognostic models for patients having glioblastoma (GBM) lesions. In particular, different MR perfusion based markers describing vascular intrapatient heterogeneity have been correlated with tumor aggressiveness, and represent key information to understand tumor resistance against effective therapies of these neoplasms. Recently, hemodynamic tissue signature (HTS) markers based on MR perfusion images have been demonstrated to be useful for describing the heterogeneity of GBM at the voxel level, as well as demonstrating significant correlations with the patient's overall survival. In this work, we analyze the abilities of these markers to improve the conventional prognostic models based on clinical, morphological, and demographic features. Our results, in both the regression and classification tests, show that inclusion of the HTS markers improves the reliability of prognostic models. The HTS method is fully automatic and it is available for research use at http://www.oncohabitats.upv.es.

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Section: Introductionsupporting

confidence: 86%

Improving the estimation of prognosis for glioblastoma patients by MR based hemodynamic tissue signatures

et al. 2018

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“…K trans has been positively correlated with tumor grade, although the direct relationship between K trans and prognosis is unclear. Several studies have found that K trans is associated with worse progression‐free and overall survival, while one study found the opposite and another study found no correlation . k ep represents the rate of flow from the extravascular space into the plasma.…”

Section: Discussionmentioning

confidence: 97%

“…Data on the role of k ep are limited. While one study found k ep to be a positive prognostic factor for overall survival, 30 another study found the opposite relationship, and found k ep to be a strong predictor of matrix metalloproteinase 9 expression. 31 Our findings of higher K trans and k ep predicting poorer overall survival in only the TERT-mutated group suggest that the relationship between survival and permeability may be more tightly coupled in the presence of TERT mutation.…”

Section: Discussionmentioning

confidence: 97%

“…Data on the role of k ep are limited. While one study found k ep to be a positive prognostic factor for overall survival, another study found the opposite relationship, and found k ep to be a strong predictor of matrix metalloproteinase 9 expression …”

Section: Discussionmentioning

confidence: 99%

“…Several studies have found that K trans is associated with worse progression-free and overall survival, 17,28,29 while one study found the opposite 25 and another study found no correlation. 30 k ep represents the rate of flow from the extravascular space into the plasma. Data on the role of k ep are limited.…”

Section: Discussionmentioning

confidence: 99%

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MRI Features Associated with TERT Promoter Mutation Status in Glioblastoma

Ivanidze

Lum

Pisapia

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Telomerase reverse transcriptase (TERT) promoter mutations are associated with worse prognosis in glioblastoma. The purpose of this study was to evaluate whether TERT mutation status was associated with specific morphologic and quantitative imaging features. METHODS Twenty‐nine patients with isocitrate dehydrogenase 1/2‐wildtype glioblastoma (13 TERT‐wildtype, 16 TERT‐mutated), who underwent preoperative magnetic resonance (MR) imaging were included in this retrospective study. Qualitative imaging phenotypes were evaluated using the Visually Accessible Rembrandt Images (VASARIs) feature set. Histogram analysis of apparent diffusion coefficient (ADC) and dynamic contrast‐enhanced MR perfusion values were performed on enhancing tumor volumes‐of‐interest, and differences between TERT‐wildtype and TERT‐mutated tumors were assessed. RESULTS VASARI analysis demonstrated that the majority of morphologic features were not significantly different between TERT‐wildtype and TERT‐mutated tumors, although a higher proportion of TERT‐wildtype tumors featured nonenhancing tumor crossing midline (P = .014). TERT‐mutated tumors demonstrated lower median rate constant kep (.38 vs. .76, P = .03) and lower median volume transfer coefficient Ktrans (.13 vs. .31, P = .02). There was no significant difference in median plasma volume vp (P = .92) or ADC values (P = .66) between the two groups. We further found a significant interaction between median kep and Ktrans and TERT status, respectively, suggesting greater risk of death with increasing blood‐brain barrier dysfunction in TERT‐mutated but not in TERT‐wildtype tumors. CONCLUSION Our study demonstrates evidence of altered permeability metrics associated with TERT mutation in glioblastoma, laying the foundation for future prospective studies assessing implications for therapeutic management and clinical outcomes.

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Quantitative vs. semiquantitative assessment of intratumoral susceptibility signals in patients with different grades of glioma

Bhattacharjee

Gupta

Patir

et al. 2019

Magnetic Resonance Imaging

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Background: Susceptibility weighted imaging (SWI) provides vascular information and plays an important role in improving the diagnostic accuracy of preoperative glioma grading. Intratumoral susceptibility signal intensities (ITSS) obtained from SWI has been used in glioma grading. However, the current method for estimation of ITSS is semiquantitative, manual count-dependent, and includes hemorrhage as well as vasculature. Purpose: To develop a quantitative approach that calculates the vasculature volume within tumors by filtering out the hemorrhage from ITSS using R 2 * values and connected component analysis-based segmentation algorithm; to evaluate the accuracy of the proposed ITSS vasculature volume (IVV) for differentiating various grades of glioma; and compare it with reported semiquantitative ITSS approach. Study Type: Retrospective. Subjects: Histopathologically confirmed 41 grade IV, 19 grade III, and 15 grade II glioma patients.Field Strength/Sequence: SWI (four echoes: 5.6, 11.8, 18, 24.2 msec) along with conventional MRI sequences (T 2 -weighted, T 1 -weighted, 3D-fluid-attenuated inversion recovery [FLAIR], and diffusion-weighted imaging [DWI]) at 3.0T. Assessment: R 2 * relaxation maps were calculated from multiecho SWI. The R 2 * cutoff value for hemorrhage ITSS was determined. A segmentation algorithm was designed, based on this R 2 * hemorrhage combined with connected component shape analysis, to quantify the IVV from all slices containing tumor by filtering out hemorrhages. Semiquantitative ITSS scoring as well as total ITSS volume (TIV) including hemorrhages were also calculated. Statistical Tests: One-way analysis of variance (ANOVA) and Tukey-Kramer post-hoc tests were performed to see the difference among the three grades of the tumor (II, III, and IV) in terms of semiquantitative ITSS scoring, TIV, and IVV. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the three methods individually in discriminating between grades of glioma. Results: One-way ANOVA showed that only the proposed IVV significantly differentiated different grades of gliomas having visible ITSS. ROC analysis showed that IVV provided the highest AUC for the discrimination of grade II vs. III (0.93), grade III vs. IV (0.98), and grade II vs. IV glioma (0.94). IVV also provided the highest sensitivity and specificity for differentiating grade II vs. III (87.44, 98.41), grade III vs. IV (97.15, 94.12), and grade II vs. IV (98.72, 92.31). Data Conclusion: The proposed quantitative method segregates hemorrhage from tumor vasculature. It scores above the existing semiquantitative method in terms of ITSS estimation and grading accuracy.

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

Cited by 49 publications

References 55 publications

Improving the estimation of prognosis for glioblastoma patients by MR based hemodynamic tissue signatures

Improving the estimation of prognosis for glioblastoma patients by MR based hemodynamic tissue signatures

MRI Features Associated with TERT Promoter Mutation Status in Glioblastoma

Quantitative vs. semiquantitative assessment of intratumoral susceptibility signals in patients with different grades of glioma

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