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Survival analysis in patients with newly diagnosed primary glioblastoma multiforme using pre- and post-treatment peritumoral perfusion imaging parameters

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Abstract

The objective of this study was to evaluate if peritumoral (PT) perfusion parameters obtained from dynamic susceptibility weighted contrast enhanced perfusion MRI can predict overall survival (OS) and progression free survival (PFS) in patients with newly diagnosed glioblastoma multiforme (GBM). Twenty-eight newly diagnosed GBM patients, who were treated with resection followed by concurrent chemoradiation and adjuvant chemotherapy, were included in this study. Evaluated perfusion parameters were pre- and post-treatment PT relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF). Proportional hazard analysis was used to assess the relationship OS, PFS and perfusion parameters. Kaplan–Meier survival estimates and log-rank test were used to characterize and compare the patient groups with high and low perfusion parameter values in terms of OS and PFS. Pretreatment PT rCBV and rCBF were not associated with OS and PFS whereas there was statistically significant association of both posttreatment PT rCBV and rCBF with OS and posttreatment rCBV with PFS (association of PFS and posttreatment rCBF was not statistically significant). Neither the Kaplan–Meier survival estimates nor the log-rank test demonstrated any differences in OS between high and low pretreatment PT rCBV values and rCBF values; however, high and low post-treatment PT rCBV and rCBF values did demonstrate statistically significant difference in OS and PFS. Our study found posttreatment, not pretreatment, PT perfusion parameters can be used to predict OS and PFS in patients with newly diagnosed GBM.

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Conflict of interest

Asim K. Bag is consultant to “Dotarem Advisory Board”, Guerbet, LLC. Other authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, The University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL, 35249-6830, USA

    Asim K. Bag & Jake J. Davenport

  2. Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-7117, USA

    Santhosh Gaddikeri

  3. Department of Neurology, The University of Alabama at Birmingham, FOT 1020, 510 20th Street South, Birmingham, AL, 35294-3410, USA

    Phillip C. Cezayirli, Hassan M. Fathallah-Shaykh, Xiaosi S. Han & Louis B. Nabors

  4. Department of Preventive Medicine, The University of Alabama at Birmingham, MT 627, 1717 11th Avenue South, Birmingham, AL, 35294-4410, USA

    Alan Cantor

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Bag, A.K., Cezayirli, P.C., Davenport, J.J. et al. Survival analysis in patients with newly diagnosed primary glioblastoma multiforme using pre- and post-treatment peritumoral perfusion imaging parameters. J Neurooncol 120, 361–370 (2014). https://doi.org/10.1007/s11060-014-1560-9

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  • DOI: https://doi.org/10.1007/s11060-014-1560-9

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