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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Cluster Analysis of DSC MRI, Dynamic Contrast-Enhanced MRI, and DWI Parameters Associated with Prognosis in Patients with Glioblastoma after Removal of the Contrast-Enhancing Component: A Preliminary Study

H. Chung, H. Seo, S.H. Choi, C.-K. Park, T.M. Kim, S.-H. Park, J.K. Won, J.H. Lee, S.-T. Lee, J.Y. Lee, I. Hwang, K.M. Kang and T.J. Yun
American Journal of Neuroradiology November 2022, 43 (11) 1559-1566; DOI: https://doi.org/10.3174/ajnr.A7655
H. Chung
aFrom the Seoul National University College of Medicine (H.C., H.S.), Seoul, Korea
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H. Seo
aFrom the Seoul National University College of Medicine (H.C., H.S.), Seoul, Korea
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S.H. Choi
bDepartment of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
cCenter for Nanoparticle Research (S.H.C.), Institute for Basic Science, Seoul, Korea
dSchool of Chemical and Biological Engineering (S.H.C.), Seoul National University, Seoul, Korea
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C.-K. Park
eDepartment of Neurosurgery (C.-K.P.), Internal Medicine
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T.M. Kim
fCancer Research Institute (T.M.K.)
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S.-H. Park
gDepartments of Pathology (S.-H.P., J.K.W.), Radiation Oncology
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J.K. Won
gDepartments of Pathology (S.-H.P., J.K.W.), Radiation Oncology
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J.H. Lee
hCancer Research Institute (J.H.L.)
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S.-T. Lee
iNeurology (S.-T.L.), Seoul National University Hospital, Seoul, Korea
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J.Y. Lee
bDepartment of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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I. Hwang
bDepartment of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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K.M. Kang
bDepartment of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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T.J. Yun
bDepartment of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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  • FIG 1.
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    FIG 1.

    Kaplan-Meier survival curves stratified on the basis of the optimal class 4r cut-point value (9.70%) for PFS and the number at risk table (blue). Kaplan-Meier curve with class 4r ≥ 9.70% (yellow). Kaplan-Meier curve with class 4r < 9.70%. Two KM curves showed a statistically significant difference (P = .037).

  • FIG 2.
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    FIG 2.

    A representative case of a patient with a PFS < 1 year (PFS = 6.73 months) after the operation. A, Depiction of the preoperative 3D CE-T1WI and FLAIR images, segmentation of the NE-T2HSIL, and nCBV, ADC, Ktrans maps derived from DSC MR imaging, DWI, and DCE MR imaging, respectively. B, 2D plots defined by the clustered voxels within the NE-T2HSIL based on the nCBV, ADC, and Ktrans maps.

  • FIG 3.
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    FIG 3.

    A representative case of a patient with a PFS of >1 year (PFS = 7.97 years) after the operation. A, Depiction of the preoperative 3D CE-T1WI and FLAIR images, segmentation of the NE-T2HSIL, and nCBV, ADC, Ktrans maps derived from DSC MR imaging, DWI, and DCE MR imaging, respectively. B, 2D plots defined by the clustered voxels within the NE-T2HSIL based on the nCBV, ADC, and Ktrans maps.

Tables

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    Table 1:

    Clinical characteristics of the study population

    CharacteristicsMean (SD) or No. (%)
    Age (yr)56.0 (13.2)
    Sex
     Male85 (59.9%)
     Female57 (40.1%)
    IDH1
     Wild-type133 (93.4%)
     Mutant9 (6.3%)
    MGMT promoter
     Unmethylated68 (47.9%)
     Methylated74 (52.1%)
    • View popup
    Table 2:

    Univariate Cox proportional hazard analysis of the potential prognostic factors for 1-year PFS

    VariablesHazard RatioWaldP Value
    Age1.023.90.047
    Sex
     Female0.703.40.066
    Preoperative KPS0.983.74.054
    IDH1 mutation
     Mutant0.217.10.008
    MGMT promoter
     Methylated0.3135<.001
    NE-T2HSIL volume
     Class 11.000.08.78
     Class 21.000.32.57
     Class 31.000.00.98
     Class 41.002.30.13
     Class 51.000.01.92
     Class 61.000.59.44
    NE-T2HSIL VF
     Class 1r0.840.02.89
     Class 2r0.660.46.50
     Class 3r2.690.02.90
     Class 4r3.043.90.048
     Class 5r0.590.51.47
     Class 6r0.640.46.50
    • Note:—KPS, karnofsky performance status; VF, volume fraction.

    • View popup
    Table 3:

    Multivariate Cox proportional hazard analysis to analyze significant independent predictors of 1-year PFS

    VariablesHazard Ratio95% CIP Value
    NE-T2HSIL VF
     Class 4r3.361.17–9.63.024
    Age1.021.00–1.04.014
    IDH10.440.13–1.45.178
    MGMT promoter0.270.17–0.41<.001
    • Note:—VF indicates volume fraction.

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American Journal of Neuroradiology: 43 (11)
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Vol. 43, Issue 11
1 Nov 2022
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H. Chung, H. Seo, S.H. Choi, C.-K. Park, T.M. Kim, S.-H. Park, J.K. Won, J.H. Lee, S.-T. Lee, J.Y. Lee, I. Hwang, K.M. Kang, T.J. Yun
Cluster Analysis of DSC MRI, Dynamic Contrast-Enhanced MRI, and DWI Parameters Associated with Prognosis in Patients with Glioblastoma after Removal of the Contrast-Enhancing Component: A Preliminary Study
American Journal of Neuroradiology Nov 2022, 43 (11) 1559-1566; DOI: 10.3174/ajnr.A7655

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DSC MRI and DWI Prognosis in Glioblastoma
H. Chung, H. Seo, S.H. Choi, C.-K. Park, T.M. Kim, S.-H. Park, J.K. Won, J.H. Lee, S.-T. Lee, J.Y. Lee, I. Hwang, K.M. Kang, T.J. Yun
American Journal of Neuroradiology Nov 2022, 43 (11) 1559-1566; DOI: 10.3174/ajnr.A7655
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