Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting

Caseiras, Gisele Brasil; Chheang, Sophie; Babb, James S.; Rees, Jeremy; Pecerrelli, Nicole; Tozer, Daniel J.; Benton, Christopher E.; Zagzag, David; Johnson, Glyn; Waldman, Adam D.; Jäger, Hans Rolf; Law, Meng

doi:10.1016/j.ejrad.2008.11.005

Cited by 71 publications

(46 citation statements)

References 21 publications

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“…Our results suggest that the previously described confounding effect of elevated rCBV measurements in lowgrade oligodendroglial tumors 18,21 becomes less significant in the prediction of disease progression when evaluating a longer endpoint, specifically two-year PFS. This study shows that the use of baseline rCBV measurements is a robust method to predict glioma prognosis, as our findings are similar to those of Law et al 23 and Caseiras et al 27 despite the fact…”

Section: Resultssupporting

confidence: 81%

“…Various studies 14,16,[18][19][20][21][22] have shown that rCBV measurements predict prognosis in parallel with histological grade and overcome the limitation of sampling errors 10 . rCBV measurements were useful to predict low-grade glioma prognosis also when data obtained at two different institutions were combined 23 . In a recent retrospective study Bisdas et al 18 established that rCBV values are predictive of recurrence and one-year survival in pure astrocytomas, but not when the entire study cohort including astrocytic and oligodendroglial tumors was considered, and that rCBV values may be a useful adjunct to histopathologic grading in predicting prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

et al. 2013

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Section: Resultssupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

et al. 2013

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“…Moreover, a strong correlation has been described between regional cerebral blood volume and outcome, independently of the WHO grading. Accordingly, high perfusion has been identified as an unfavorable prognostic factor in astrocytomas (38)(39)(40). Future studies correlating perfusion-weighted MR imaging and dynamic 18 F-FET PET data are needed to further test this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Dynamic ¹⁸F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients

Jansen¹,

Suchorska

Wenter³

et al. 2013

J Nucl Med

127

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Because the clinical course of low-grade gliomas in the individual adult patient varies considerably and is unpredictable, we investigated the prognostic value of dynamic 18 F-fluorethyltyrosine ( 18 F-FET) PET in the early diagnosis of astrocytic low-grade glioma (World Health Organization grade II). Methods: Fifty-nine patients with newly diagnosed low-grade glioma and dynamic 18 F-FET PET before histopathologic assessment were retrospectively investigated. 18 F-FET PET analysis comprised a qualitative visual classification of lesions; assessment of the semiquantitative parameters maximal, mean, and total standardized uptake value as ratio to background and biologic tumor volume; and dynamic analysis of intratumoral 18 F-FET uptake over time (increasing vs. decreasing time-activity curves). The correlation between PET parameters and progression-free survival, overall survival, and time to malignant transformation was investigated. Results: 18 F-FET uptake greater than the background level was found in 34 of 59 tumors. Dynamic 18 F-FET uptake analysis was available for 30 of these 34 patients. Increasing and decreasing timeactivity curves were found in 18 and 12 patients, respectively. Neither the qualitative factor presence or absence of 18 F-FET uptake nor any of the semiquantitative uptake parameters significantly influenced clinical outcome. In contrast, decreasing time-activity curves in the kinetic analysis were highly prognostic for shorter progression-free survival and time to malignant transformation (P , 0.001). Conclusion: Absence of 18 F-FET uptake in newly diagnosed astrocytic low-grade glioma does not generally indicate an indolent disease course. Among the 18 F-FET-positive gliomas, decreasing time-activity curves in dynamic 18 F-FET PET constitute an unfavorable prognostic factor in astrocytic low-grade glioma and, by identifying high-risk patients, may ease treatment decisions.

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“…The biomarkers of microvascular structure and function are increasingly demonstrating clinical potential in a variety of roles (90), such as: differentiating abscess and tumor (107), differentiating lymphoma and glioma (108,109), differentiating tumefactive demyelinating lesions from intracranial neoplasms (93), predicting transformation of LGG (110,111), predicting therapeutic respons and prognosis in HGGs (112), and in distinguishing tumor recurrence and radiation necrosis (113).…”

Section: Other Applications Of Perfusion Mrimentioning

confidence: 99%

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

et al. 2009

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Background: Conventional magnetic resonance (MR) imaging has a number of limitations in the diagnosis of the most common intracranial brain tumors, including tumor specification and the detection of tumoral infiltration in regions of peritumoral edema. Purpose: To prospectively assess if diffusion-weighted MR imaging (DWI) could be used to differentiate between different types of brain tumors and to distinguish between peritumoral infiltration in high-grade gliomas, lymphomas, and pure vasogenic edema in metastases and meningiomas. Material and Methods: MR imaging and DWI was performed on 93 patients with newly diagnosed brain tumors: 59 patients had histologically verified high-grade gliomas (37 glioblastomas multiforme, 22 anaplastic astrocytomas), 23 patients had metastatic brain tumors, five patients had primary cerebral lymphomas, and six patients had meningiomas. Apparent diffusion coefficient (ADC) values of tumor (enhancing regions or the solid portion of tumor) and peritumoral edema, and ADC ratios (ADC of tumor or peritumoral edema to ADC of contralateral white matter, ADC of tumor to ADC of peritumoral edema) were compared with the histologic diagnosis. ADC values and ratios of high-grade gliomas, primary cerebral lymphomas, metastases, and meningiomas were compared by using ANOVA and multiple comparisons. Optimal thresholds of ADC values and ADC ratios for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results: Statistically significant differences were found for minimum and mean of ADC tumor and ADC tumor ratio values between metastases and high-grade gliomas when including only one factor at a time. Including a combination of in total four parameters (mean ADC tumor, and minimum, maximum and mean ADC tumor ratio) resulted in sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 72.9, 82.6, 91.5, and 54.3% respectively. In the ROC curve analysis, the area under the curve of the combined four parameters was the largest (0.84), indicating a good test. Conclusion: Our results suggest that ADC values and ADC ratios (minimum and mean of ADC tumor and ADC tumor ratio) may be helpful in the differentiation of metastases from high-grade gliomas. It cannot distinguish high-grade gliomas from lymphomas, and lymphomas from metastases. ADC values and ADC ratios in peritumoral edema cannot be used to differentiate edema with infiltration of tumor cells from vasogenic edema when measurements for high-grade gliomas, lymphomas, metastases, and meningiomas were compared.

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Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting

Cited by 71 publications

References 21 publications

Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

Dynamic ¹⁸F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

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Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting

Cited by 71 publications

References 21 publications

Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

Correlation between Cerebral Blood Volume Measurements by Perfusion-Weighted Magnetic Resonance Imaging and Two-Year Progression-Free Survival in Gliomas

Dynamic 18F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

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Dynamic ¹⁸F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients