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

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig 1.
A 64-year-old patient with glioblastoma who had early disease progression (PFS = 14 months) after standard treatment. The preoperative axial contrast-enhanced T1WI (A) and FLAIR (B) images represent an enhancing area and nonenhancing FLAIR high-signal-intensity lesions, respectively. The preoperative parametric maps of contrast leakage information (EF, K^trans, Ve, and Vp) are shown (C, D, E, and F, respectively). A low EF value on the nonenhancing FLAIR high-signal-intensity lesion was observed, with an EF 95th percentile value of 5.67.
Download figure
Open in new tab
Download powerpoint
Fig 2.
A 60-year-old patient with glioblastoma who had nonprogression (PFS = 31 months) after standard treatment. The preoperative axial contrast-enhanced T1WI (A) and FLAIR (B) images represent an enhancing area and a nonenhancing FLAIR high-signal-intensity lesion, respectively. The preoperative parametric maps of contrast leakage information (EF, K^trans, Ve, and Vp) are shown (C, D, E, and F, respectively). A high EF value on a nonenhancing FLAIR high-signal-intensity lesion was noted, with an EF 95th percentile value of 16.69.

Table 1:

Clinical characteristics of the study population^{^a}

Characteristics	Total (n = 102)	Progression (n = 87)	Nonprogression (n = 15)	P Value
Mean age (yr)	56.9	59.2 ± 13.5	51.3 ± 14.0	.04^{^b}
Mean radiation dose (Gy)	51.9	52.5 ± 18.4	48.6 ± 0.6	.43^{^b}
Sex				.40^{^c}
Male	59	52	7
Female	43	35	8
Methylated MGMT promoter				.09^{^c}
Positive	59	47	12
Negative	42	39	3
IDH1/2 mutation				.28^{^c}
Positive	7	5	2
Negative	94	81	13

Table 2:

Comparison of the parametric values of the progression and nonprogression groups^{^a}

Parameters	Progression (n = 71)	Nonprogression (n = 15)	P Value^{^b}
Mean tumor volume (mL)	119.84 ± 85.65	161.81 ± 102.59	.10
EF 95th PV (%)	11.053 ± 7.651	15.790 ± 8.693	.04
EF mean (%)	2.473 ± 1.552	3.140 ± 1.463	.13
K^trans 95th PV (min^–1)	0.140 ± 0.118	0.177 ± 0.132	.28
K^trans mean (min^–1)	0.022 ± 0.024	0.0260 ± 0.021	.59
Ve 95th PV	51.604 ± 71.965	44.480 ± 29.773	.71
Ve mean	7.750 ± 16.050	6.209 ± 4.917	.71
Vp 95th PV	5.334 ± 5.488	6.594 ± 4.807	.41
Vp mean	1.264 ± 1.352	1.384 ± 0.100	.75

Note:—PV indicates percentile value.
↵a Patients with a follow-up period of >24 months without progression (n = 15) or PFS of ≤24 months (n = 71) were analyzed.
↵b Calculated with an unpaired Student t test.