Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting

Caseiras, Gisele B.; Chheang, Sophie; Babb, James; Rees, Jeremy H.; Pecerrelli, Nicole; Tozer, Daniel J.; Benton, Christopher; Zagzag, David; Johnson, Glyn; Waldman, Adam D.; Jäger, H.R.; Law, Meng

doi:10.1016/j.ejrad.2008.11.005

« Previous Next »European Journal of Radiology
Volume 73, Issue 2 , Pages 215-220, February 2010

Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting

Gisele B. Caseiras
- Institute of Neurology, UCL, London SW1X 0HZ, UK
- Corresponding author. Tel.: +44 7810447422; fax: +44 2072785616.
Sophie Chheang
- Department of Radiology, New York University Medical Center, New York, NY, USA
James Babb
- Department of Radiology, New York University Medical Center, New York, NY, USA
Jeremy H. Rees
- Institute of Neurology, UCL, London SW1X 0HZ, UK
Nicole Pecerrelli
- Department of Radiology, New York University Medical Center, New York, NY, USA
Daniel J. Tozer
- Institute of Neurology, UCL, London SW1X 0HZ, UK
Christopher Benton
- Institute of Neurology, UCL, London SW1X 0HZ, UK
David Zagzag
- Department of Pathology and Neurosurgery, New York University Medical Center, New York, NY, USA
Glyn Johnson
- Department of Radiology, New York University Medical Center, New York, NY, USA
Adam D. Waldman
- Institute of Neurology, UCL, London SW1X 0HZ, UK
- Imperial College of Science Technology and Medicine, London, UK
H.R. Jäger
- Institute of Neurology, UCL, London SW1X 0HZ, UK
Meng Law
- Department of Radiology and Neurosurgery, Mount Sinai Medical Center, New York, NY, USA

Received 25 July 2008; received in revised form 8 November 2008; accepted 10 November 2008.

Abstract

Background/purpose

The prognostic value of defining subcategories of gliomas is still controversial. This study aims to determine the utility of relative cerebral blood volume (rCBV) in predicting clinical response in patients with low-grade glioma at multiple institutions.

Materials and methods

Sixty-nine patients were studied with dynamic susceptibility contrast-enhanced perfusion MRI at two institutions. The pathologic diagnoses of the low-grade gliomas were 34 astrocytomas, 20 oligodendroglioma, 9 oligoastrocytomas, 1 ganglioglioma and 5 with indeterminate histology.

Wilcoxon tests were used to compare patients in different response categories with respect to baseline rCBV. Kaplan–Meier curve and log-rank tests were used to predict the association of rCBV with time to progression.

Results

At both institutions, patients with an adverse event (progressive disease or death) had a significantly higher baseline rCBV than those without (complete response or stable disease) (p value=0.0138).

The odds ratio for detecting an adverse event when using rCBV was 1.87 (95% confidence interval: 1.14–3.08). rCBV was significantly negatively associated with time to progression (p=0.005). The median time to progression among subjects with rCBV>1.75 was 365 days, while there was 95% confidence that the median time to progression was at least 889 days among subjects with rCBV<1.75.

Conclusion

Our study suggests not only that rCBV measurements correlate well with time to progression or death, but also that the findings can be replicated across institutions, which supports the application of rCBV as an adjunct to pathology in predicting glioma biology.

Keywords: Brain tumours, Perfusion, rCBV, Outcome