Gliomas: Predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging
Gliomas: Predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging
复制标题
DOI：
10.1148/radiol.2472070898
复制
发表时间：
2008-05-01
期刊：
影响因子：
19.7
通讯作者：
Johnson, Glyn
中科院分区：
文献类型：
--
作者：
Law, Meng;Young, Robert J.;Johnson, Glyn
目的：回顾性确定相对脑血容量（CBV）测量是否可用于预测高级别胶质瘤（HGGs）和低级别胶质瘤（LGGs）患者的临床结果，特别是初始相对CBV高的胶质瘤患者是否比相对CBV低的胶质瘤患者进展更快。材料和方法：这项符合hipaa的回顾性研究获得了研究协会机构委员会的批准，并放弃了知情同意。189例患者（男122例，女67例，中位年龄43岁，年龄范围4 ~ 80岁）行动态敏感性加权造影剂增强灌注磁共振（MR）成像检查，并进行临床mri随访（中位随访334天）。Log-rank检验采用Kaplan-Meier曲线评价相对CBV与进展时间之间的关系。使用二元逻辑回归来确定年龄、性别和相对CBV是否与不良事件（进展性疾病或死亡）相关。结果：根据每项临床反应，患者的平均相对CBV值为：完全缓解（n = 4）为1.41 +/- 0.13（标准差），疾病稳定（n = 41）为2.36 +/- 1.78，疾病进展（n = 130）为4.84 +/- 3.32，死亡（n = 14）为3.82 +/- 1.93。Kaplan-Meier估计的中位进展时间（以天为单位）表明，相对CBV小于1.75的患者的中位进展时间为3585天，而相对CBV大于1.75的患者的中位进展时间为265天。年龄和相对CBV也是临床结果的独立预测因子。结论：动态敏感性加权对比增强灌注磁共振成像可用于预测胶质瘤患者的中位进展时间，而不依赖于病理表现。具有高相对CBV （bbb1.75）的HGGs和LGGs患者比具有低相对CBV的胶质瘤患者有明显更快的进展时间。
Purpose:To retrospectively determine whether relative cerebral blood volume (CBV) measurements can be used to predict clinical outcome in patients with high-grade gliomas (HGGs) and low-grade gliomas (LGGs) and specifically whether patients who have gliomas with a high initial relative CBV have more rapid progression than those who have gliomas with a low relative CBV.Materials and Methods:Approval for this retrospective HIPAA-compliant study was obtained from the Institutional Board of Research Associates, with waiver of informed consent. One hundred eighty-nine patients (122 male and 67 female patients; median age, 43 years; range, 4-80 years) were examined with dynamic susceptibility-weighted contrast material enhanced perfusion magnetic resonance (MR) imaging and were followed up clinically with MR imaging (median follow-up, 334 days). Log-rank tests were used to evaluate the association between relative CBV and time to progression by using Kaplan-Meier curves. Binary logistic regression was used to determine whether age, sex, and relative CBV were associated with an adverse event (progressive disease or death).Results:Values for the mean relative CBV for patients according to each clinical response were as follows: 1.41 +/- 0.13 (standard deviation) for complete response (n = 4), 2.36 +/- 1.78 for stable disease (n = 41), 4.84 +/- 3.32 for progressive disease (n = 130), and 3.82 +/- 1.93 for death (n = 14). Kaplan-Meier estimates of median time to progression in days indicated that patients with a relative CBV of less than 1.75 had a median time to progression of 3585 days, whereas patients with a relative CBV of more than 1.75 had a time to progression of 265 days. Age and relative CBV were also independent predictors for clinical outcome.Conclusion:Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging can be used to predict median time to progression in patients with gliomas, independent of pathologic findings. Patients who have HGGs and LGGs with a high relative CBV (>1.75) have a significantly more rapid time to progression than do patients who have gliomas with a low relative CBV.