Open AccessPerfusion of surgical cavity wall enhancement in early post-treatment MR imaging may stratify the time-to-progression in glioblastoma
Author(s) -
Ji Eun Park,
Kyoung Hwa Ryu,
Ho Sung Kim,
Hyo Won Kim,
Woo Hyun Shim,
Sung Eun Jung,
Choong Gon Choi,
Sang Joon Kim
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0181933
Subject(s) - glioblastoma , medicine , magnetic resonance imaging , perfusion , radiology , perfusion scanning , nuclear medicine , pathology , cancer research
Objective To determine if perfusion in surgical cavity wall enhancement (SCWE) obtained in early post-treatment MR imaging can stratify time-to-progression (TTP) in glioblastoma. Materials and methods This study enrolled 60 glioblastoma patients with more than 5-mm-thick SCWEs as detected on contrast-enhanced MR imaging after concurrent chemoradiation therapy. Two independent readers categorized the shape and perfusion state of SCWEs as nodular or non-nodular and as having positive or negative perfusion compared with the contralateral grey matter on arterial spin labeling (ASL). The perfusion fraction on ASL within the contrast-enhancing lesion was calculated. The independent predictability of TTP was analyzed using the Kaplan-Meier method and Cox proportional hazards modelling. Results The perfusion fraction was higher in the non-progression group, significantly for reader 2 ( P = 0.03) and borderline significantly for reader 1 ( P = 0.08). A positive perfusion state and ( P = 0.02) a higher perfusion fraction of the SCWE were found to become an independent predictor of longer TTP ( P = 0.001 for reader 1 and P < 0.001 for reader 2). The contrast enhancement pattern did not become a TTP predictor. Conclusion Assessment of perfusion in early post-treatment MR imaging can stratify TTP in patients with glioblastoma for adjuvant temozolomide therapy. Positive perfusion in SCWEs can become a predictor of a longer TTP.