Evaluating survival in subjects with astrocytic brain tumors by dynamic susceptibility-weighted perfusion MR imaging

• Published in: PloS one Vol. 16; no. 1; p. e0244275
• Main Authors: White, Matthew L., Zhang, Yan, Kazmi, Syed A. Jaffar, Aizenberg, Michele, Shonka, Nicole, Yu, Fang, Appiah, Adams Kusi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.01.2021; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Alkylating - therapeutic use; Astrocytes; Astrocytoma - diagnostic imaging; Astrocytoma - drug therapy; Astrocytoma - mortality; Astrocytoma - pathology; Biology and Life Sciences; Biomarkers; Biopsy; Brain; Brain cancer; Brain Mapping; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - drug therapy; Brain Neoplasms - mortality; Brain Neoplasms - pathology; Brain tumors; Classification; Consent; Databases, Factual; Evaluation; Glioma; Health aspects; Humans; Kaplan-Meier Estimate; Magnetic Resonance Angiography; Magnetic resonance imaging; Male; Medical imaging; Medical prognosis; Medical records; Medicine and Health Sciences; Meglumine - analogs & derivatives; Meglumine - chemistry; Methods; Middle Aged; Multivariate analysis; Neuroimaging; Organometallic Compounds - chemistry; Patients; Perfusion; Prognosis; Radiation therapy; Regression analysis; Research and Analysis Methods; Retrospective Studies; Surgery; Survival; Survival analysis; Temozolomide - therapeutic use; Tumors; Variation; Young Adult; United States; United States > US; Netherlands; Nebraska
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244275

Studies have evaluated the application of perfusion MR for predicting survival in patients with astrocytic brain tumors, but few of them statistically adjust their results to reflect the impact of the variability of treatment administered in the patients. Our aim was to analyze the association between the perfusion values and overall survival time, with adjustment for various clinical factors, including initial treatments and follow-up treatments. This study consisted of 51 patients with astrocytic brain tumors who underwent perfusion-weighted MRI with MultiHance® at a dose of 0.1 mmol/kg prior to initial surgery. We measured the mean rCBV, the 5% & 10% maximum rCBV, and the variation of rCBV in the tumors. Comparisons were made between patients with and without 2-year survival using two-sample t-test or Wilcoxon rank-sum test for the continuous data, or chi-square and Fisher exact tests for categorical data. The multivariate cox-proportional hazard regression was fit to evaluate the association between rCBV and overall survival time, with adjustment for clinical factors. Patients who survived less than 2 years after diagnosis had a higher mean and maximum rCBV and a larger variation of rCBV. After adjusting for clinical factors including therapeutic measures, we found no significant association of overall survival time within 2 years with any of these rCBV values. Although patients who survived less than 2 years had a higher mean and maximum rCBV and a larger variation of rCBV, rCBV itself may not be used independently for predicting 2-year survival of patients with astrocytic brain tumors.