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Perfusion MRI in the Evaluation of Suspected Glioblastoma Recurrence
Author(s) -
Blasel Stella,
Zagorcic Andrea,
Jurcoane Alina,
Bähr Oliver,
Wagner Marlies,
Harter Patrick N.,
Hattingen Elke
Publication year - 2015
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12247
Subject(s) - medicine , tumor progression , glioblastoma , receiver operating characteristic , brain tumor , cerebral blood volume , histopathology , radiology , perfusion , oncology , nuclear medicine , pathology , cancer , cancer research
ABSTRACT PURPOSE Treatment‐related changes (TRC) often imitate tumor progression in glioblastomas. Increased regional cerebral blood volume (rCBV) can differentiate tumor progression from TRC after the standardized first‐line radiochemotherapy, but information about diagnostic accuracy of rCBV for patients without any clinical selection criteria is limited. Therefore, we aimed to evaluate if rCBV can differentiate between TRC and tumor progression irrespective of preceding therapies and number of tumor progressions. METHODS We analyzed mean and maximum rCBV from the enhancing areas normalized to the contralateral white matter in 44 pretreated glioblastomas with MR‐morphological tumor progression. The diagnosis (real progression vs. TRC) was determined by histopathology or by clinical/MRI‐follow‐up. We performed nonparametric tests, receiver operating characteristics (ROC), and Kaplan‐Meier analysis. RESULTS Significant differences between tumor progression ( N = 37) and TRC ( N = 7) were found for rCBV mean (2.44 ± 1.05 vs. 1.69 ± .56, P < .03) and rCBV max (3.40 ± 1.25 vs. 2.21 ± .62, P < .0007). A rCBV max of 2.6 had 78% sensitivity and 86% specificity to detect tumor progression. Neither rCBV mean nor rCBV max was predictive for the patient overall survival (OS). There were no statistically different rCBV mean and rCBV max between the first and further tumor progressions. CONCLUSIONS The rCBV max differentiates tumor progression from TRC in unselected recurrent glioblastomas, but it is not predictive for the OS.