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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain
Open Access

Prognostic Predictions for Patients with Glioblastoma after Standard Treatment: Application of Contrast Leakage Information from DSC-MRI within Nonenhancing FLAIR High-Signal-Intensity Lesions

S.H. Kim, K.H. Cho, S.H. Choi, T.M. Kim, C.K. Park, S.H. Park, J.K. Won, I.H. Kim and S.T. Lee
American Journal of Neuroradiology December 2019, 40 (12) 2052-2058; DOI: https://doi.org/10.3174/ajnr.A6297
S.H. Kim
aFrom the Departments of Radiology (S.H.K., K.H.C., S.H.C.)
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K.H. Cho
aFrom the Departments of Radiology (S.H.K., K.H.C., S.H.C.)
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S.H. Choi
aFrom the Departments of Radiology (S.H.K., K.H.C., S.H.C.)
dCenter for Nanoparticle Research (S.H.C.), Institute for Basic Science, Seoul, Korea
eSchool of Chemical and Biological Engineering (S.H.C.), Seoul National University, Seoul, Korea
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T.M. Kim
fDepartments of Internal Medicine (T.M.K.)
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C.K. Park
hDepartment of Neurosurgery (C.K.P.), Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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S.H. Park
bPathology (S.H.P., J.K.W.)
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J.K. Won
bPathology (S.H.P., J.K.W.)
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I.H. Kim
gRadiation Oncology (I.H.K.), Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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S.T. Lee
cNeurology (S.T.L.), Seoul National University College of Medicine, Seoul, Korea
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Abstract

BACKGROUND AND PURPOSE: Attempts have been made to quantify the microvascular leakiness of glioblastomas and use it as an imaging biomarker to predict the prognosis of the tumor. The purpose of our study was to evaluate whether the extraction fraction value from DSC-MR imaging within nonenhancing FLAIR hyperintense lesions was a better prognostic imaging biomarker than dynamic contrast-enhanced MR imaging parameters for patients with glioblastoma.

MATERIALS AND METHODS: A total of 102 patients with glioblastoma who received a preoperative dynamic contrast-enhanced MR imaging and DSC-MR imaging were included in this retrospective study. Patients were classified into the progression (n = 87) or nonprogression (n = 15) groups at 24 months after surgery. We extracted the means and 95th percentile values for the contrast leakage information parameters from both modalities within the nonenhancing FLAIR high-signal-intensity lesions.

RESULTS: The extraction fraction 95th percentile value was higher in the progression-free survival group of >24 months than at ≤24 months. The median progression-free survival of the group with an extraction fraction 95th percentile value of >13.32 was 17 months, whereas that of the group of ≤13.32 was 12 months. In addition, it was an independent predictor variable for progression-free survival in the patients regardless of their ages and genetic information.

CONCLUSIONS: The extraction fraction 95th percentile value was the only independent parameter for prognostic prediction in patients with glioblastoma among the contrast leakage information, which has no statistically significant correlations with the DCE-MR imaging parameters.

ABBREVIATIONS:

DCE
dynamic contrast-enhanced
EF
extraction fraction
Ktrans
volume transfer constant
MGMT
O6-methylguanine methyltransferase
PFS
progression-free survival
Ve
volume of extravascular extracellular space
Vp
volume of vascular plasma space
IDH
isocitrate dehydrogenase
  • © 2019 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 40 (12)
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1 Dec 2019
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S.H. Kim, K.H. Cho, S.H. Choi, T.M. Kim, C.K. Park, S.H. Park, J.K. Won, I.H. Kim, S.T. Lee
Prognostic Predictions for Patients with Glioblastoma after Standard Treatment: Application of Contrast Leakage Information from DSC-MRI within Nonenhancing FLAIR High-Signal-Intensity Lesions
American Journal of Neuroradiology Dec 2019, 40 (12) 2052-2058; DOI: 10.3174/ajnr.A6297

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Prognostic Predictions for Patients with Glioblastoma after Standard Treatment: Application of Contrast Leakage Information from DSC-MRI within Nonenhancing FLAIR High-Signal-Intensity Lesions
S.H. Kim, K.H. Cho, S.H. Choi, T.M. Kim, C.K. Park, S.H. Park, J.K. Won, I.H. Kim, S.T. Lee
American Journal of Neuroradiology Dec 2019, 40 (12) 2052-2058; DOI: 10.3174/ajnr.A6297
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