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Erschienen in:
28.08.2014 | Original Article
Assessment of Progression-Free-Survival in Glioblastomas by Intratreatment Dynamic Contrast-Enhanced MRI
Erschienen in: Clinical Neuroradiology | Ausgabe 1/2016
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Purpose
The efficacy of concomitant chemoradiation in patients with glioblastomas (GBMs) cannot be reliably assessed until several weeks after therapy completion. Our aim was to evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as an early predictive assay for the progression-free-survival.
Methods and Materials
A total of 22 patients with primary GBMs underwent DCE-MRI before, during and after completion of adjuvant chemoradiation. K
trans (transfer constant between the intravascular and extravascular, extracellular space), v
e
(extracellular, extravascular volume) and IAUGC (initial area under the gadolinium concentration time curve) and their changes into treatment were assessed as prognostic markers (12 months of progression-free-survival (PFS)).
Results
Both responders (7 subjects) and non-responders (15 subjects) experienced a reduction in the baseline IAUGC and v
e
values during the early phase of the treatment. This reduction was more prominent in the responders and was statistically significant for the v
e
(P = 0.04). Baseline K
trans values among responders demonstrated statistically significant reduction during the early phase of treatment (P = 0.001). Multivariate Cox regression analysis demonstrated significant relationship between response and the early changes in K
trans values during the treatment (P = 0.04). Trend to significant prognostic value demonstrated the baseline K
trans, v
e
and IAUGC as well as the changes of IAUGC and K
trans upon therapy completion.
Conclusions
Early perfusion changes during concomitant chemoradiation in GBMs can be detected by means of DCE-MRI and have significant prognostic value for the 12-month PFS.