Magnetic Resonance Imaging Parameters and Their Impact on Survival of Patients with Glioblastoma: Tumor Perfusion Predicts Survival
Magnetic Resonance Imaging Parameters and Their Impact on Survival of Patients with Glioblastoma: Tumor Perfusion Predicts Survival
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DOI：
10.1016/j.wneu.2018.12.085
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发表时间：
2019-04-01
影响因子：
2
通讯作者：
Bhatia, Sanjay
中科院分区：
文献类型：
--
作者：
Hou, Bob L.;Wen, Sijin;Bhatia, Sanjay
背景：影响胶质母细胞瘤患者总体生存(OS)的预后因素很多。尽管大体全切除和Stupp方案得到遵守，但许多患者的存活率很低。方法：对36例胶质母细胞瘤患者进行了回顾性研究，评价了反映肿瘤细胞密度、血管密度和患者年龄的磁共振成像参数对OS值的影响。结果：基于最优接收器操作特征曲线的灌注参数归一化相对肿瘤血流量(NrTBV)和归一化相对肿瘤血流量(NRTBF)的曲线下面积分别为0.92和0.89，是所有成像参数和年龄中最高的。OS与校正的n_rTBV(R=-0.70；P&t；0.001)和n_rtBF(R=-0.67；P&t；0.001)呈显著负相关。包含年龄和影像参数的COX模型显示，nrTBV和nrtBF对OS的预测作用最大，风险比分别为5.97(P=0.0001)和8.76(P=0.0001)，而年龄为1.63(P=0.19)。校正n_rTBV2.5者18例。2 4例n_RTBF2.79(95%CI，1.3~4.2；P<；0.001)。结论：归一化灌注参数n_rTBV和n_RTBF是预测OS的主要指标。术前灌注成像可作为预测胶质母细胞瘤侵袭性和生存期的替代指标，不依赖于治疗。
BACKGROUND: Many prognostic factors influence overall survival (OS) of patients with glioblastoma. Despite gross total resection and Stupp protocol adherence, many patients have poor survival. Perfusion magnetic resonance imaging may assist in diagnosis, treatment monitoring, and prognostication.METHODS: This retrospective study of 36 patients with glioblastoma assessed influence of preoperative magnetic resonance imaging parameters reflecting tumor cell density and vascularity and patient age on OS.RESULTS: The area under curve based on optimal receiver operating characteristic curves for the perfusion parameters normalized relative tumor blood volume (n_rTBV) and normalized relative tumor blood flow (n_rTBF) were 0.92 and 0.89, respectively, and the highest among all imaging parameters and age. OS showed strongly negative correlations with corrected n_rTBV (R = -0.70; P < 0.001) and n_rTBF (R = -0.67; P < 0.001). The Cox model, which included age and imaging parameters, demonstrated that n_rTBV and n_rTBF were most predictive of OS, with hazard ratios of 5.97 (P = 0.0001) and 8.76 (P = 0.0001), respectively, compared with 1.63 (P = 0.19) for age. Eighteen patients with corrected n_rTBV 2.5. Twenty-four patients with n_rTBF 2.79 (95% CI, 1.31-4.2; P < 0.001).CONCLUSIONS: The dominant predictors of OS are normalized perfusion parameters n_rTBV and n_rTBF. Preoperative perfusion imaging may be used as a surrogate to predict glioblastoma aggressiveness and survival independent of treatment.