Prognostic Value of Dynamic Contrast-Enhanced MRI-Derived Pharmacokinetic Variables in Glioblastoma Patients: Analysis of Contrast-Enhancing Lesions and Non-Enhancing T2 High-Signal Intensity Lesions

• Published in: Korean journal of radiology Vol. 21; no. 6; pp. 707 - 716
• Main Authors: Kang, Yeonah, Hong, Eun Kyoung, Rhim, Jung Hyo, Yoo, Roh-Eul, Kang, Koung Mi, Yun, Tae Jin, Kim, Ji-Hoon, Sohn, Chul-Ho, Park, Sun-Won, Choi, Seung Hong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.06.2020; 대한영상의학회
• Subjects: Brain cancer; Medical prognosis; Neuroimaging and Head & Neck; Patients; Permeability; Pharmacokinetics; Reproducibility; Software; Tumors; Variables; 방사선과학; Parameter imaging; Preoperative analysis; Prognosis prediction; Glioblastoma multiforme; Dynamic contrast-enhanced MR imaging
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2019.0629

To evaluate pharmacokinetic variables from contrast-enhancing lesions (CELs) and non-enhancing T2 high signal intensity lesions (NE-T2HSILs) on dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging for predicting progression-free survival (PFS) in glioblastoma (GBM) patients. Sixty-four GBM patients who had undergone preoperative DCE MR imaging and received standard treatment were retrospectively included. We analyzed the pharmacokinetic variables of the volume transfer constant (Ktrans) and volume fraction of extravascular extracellular space within the CEL and NE-T2HSIL of the entire tumor. Univariate and multivariate Cox regression analyses were performed using preoperative clinical characteristics, pharmacokinetic variables of DCE MR imaging, and postoperative molecular biomarkers to predict PFS. The increased mean Ktrans of the CEL, increased 95th percentile Ktrans of the CELs, and absence of methylated O⁶-methylguanine-DNA methyltransferase promoter were relevant adverse variables for PFS in the univariate analysis ( = 0.041, = 0.032, and = 0.083, respectively). The Kaplan-Meier survival curves demonstrated that PFS was significantly shorter in patients with a mean Ktrans of the CEL > 0.068 and 95th percentile Ktrans of the CEL>0.223 (log-rank = 0.038 and = 0.041, respectively). However, only mean Ktrans of the CEL was significantly associated with PFS ( = 0.024; hazard ratio, 553.08; 95% confidence interval, 2.27-134756.74) in the multivariate Cox proportional hazard analysis. None of the pharmacokinetic variables from NE-T2HSILs were significantly related to PFS. Among the pharmacokinetic variables extracted from CELs and NE-T2HSILs on preoperative DCE MR imaging, the mean Ktrans of CELs exhibits potential as a useful imaging predictor of PFS in GBM patients.