American Journal of Neuroradiology 26:2466-2474, November-December 2005
© 2005 American Society of Neuroradiology
BRAIN
MR Imaging Correlates of Survival in Patients with High-Grade Gliomas
a Department of Radiological Sciences, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA
b Department of Biostatistics, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA
c Department of Human Genetics, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA
d Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA
e Department of Neurology, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA
Address correspondence to Whitney B. Pope, MD, PhD, Department of Radiological Sciences, David Geffen School of Medicine at UCLA Medical Center, 10833 Le Conte Avenue, BL-428/CHS, Los Angeles, CA 90095-1721
BACKGROUND AND PURPOSE: For patients with malignant gliomas, clinical data—including age, perioperative Karnofsky Performance Status (KPS), and tumor resection—and tumor imaging features—including necrosis and edema—have been found to correlate with survival. The purpose of this study was to assess the validity of these results and determine whether other imaging features are useful in predicting survival.
METHODS: We analyzed the relationship between 15 imaging variables obtained from contrast-enhanced MR imaging scans and survival in patients with grade III (n = 43) and grade IV (n = 110) glioblastoma multiforme (GBM) gliomas. Image analysis was performed by 2 neuroradiologists who were blinded to clinical data. The Kaplan-Meier method was used to estimate survival probabilities. Univariable Cox models were used to assess the impact of imaging features on survival. A recursive partitioning analysis also was performed.
RESULTS: As expected, age and KPS scores had significant prognostic value for both tumor grades. The extent of resection was not a statistically meaningful predictor of survival. For GBM, univariable analysis revealed the following imaging features to be significant, (hazard ratios in parentheses): noncontrast-enhancing tumor (nCET, 0.55), edema (1.62), satellites (1.74), and multifocality (4.34). For grade III tumors, the Cox hazard ratio for necrosis was 4.43 (P = .014) and correlated with a poor outcome and survival rates comparable to GBM patients. Lack of nCET, multifocality, and satellite lesions also were correlated with shortened survival.
CONCLUSION: Of 15 tumor imaging features in GBM patients, only nCET, edema, and multifocality/satellites are statistically significant prognostic indicators. The survival advantage of nCET is a novel finding.
This article has been cited by other articles:
 |
|
 |
|
  W. B. Pope, J. H. Chen, J. Dong, M. R. J. Carlson, A. Perlina, T. F. Cloughesy, L. M. Liau, P. S. Mischel, P. Nghiemphu, A. Lai, et al. Relationship between Gene Expression and Enhancement in Glioblastoma Multiforme: Exploratory DNA Microarray Analysis Radiology, October 1, 2008; 249(1): 268 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Diehn, C. Nardini, D. S. Wang, S. McGovern, M. Jayaraman, Y. Liang, K. Aldape, S. Cha, and M. D. Kuo From the Cover: Identification of noninvasive imaging surrogates for brain tumor gene-expression modules PNAS, April 1, 2008; 105(13): 5213 - 5218. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R.J. Carlson, W. B. Pope, S. Horvath, J. G. Braunstein, P. Nghiemphu, C.-L. Tso, I. Mellinghoff, A. Lai, L. M. Liau, P. S. Mischel, et al. Relationship between Survival and Edema in Malignant Gliomas: Role of Vascular Endothelial Growth Factor and Neuronal Pentraxin 2 Clin. Cancer Res., May 1, 2007; 13(9): 2592 - 2598. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. B. Pope, A. Lai, P. Nghiemphu, P. Mischel, and T. F. Cloughesy MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy Neurology, April 25, 2006; 66(8): 1258 - 1260. [Abstract] [Full Text] [PDF]
|
|