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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:853-858, April 2006
© 2006 American Society of Neuroradiology

BRAIN

Do Cerebral Blood Volume and Contrast Transfer Coefficient Predict Prognosis in Human Glioma?

S.J. Mills^a, T.A. Patankar^a, H.A. Haroon^a, D. Balériaux^c, R. Swindell^b and A. Jackson^a

^a Department of Imaging Science and Biomedical Engineering, Christie Hospital NHS Trust, Manchester, United Kingdom
^b University of Manchester, and the Department of Medical Statistics, Christie Hospital NHS Trust, Manchester, United Kingdom
^c Service de Radiologie Hôpital Erasme, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium

Address correspondence to Professor Alan Jackson, Department of Imaging Science and Biomedical Engineering, Faculty of Medicine, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom

INTRODUCTION: Noninvasive measurements of cerebral blood volume (CBV) and contrast transfer coefficient (K^trans) have potential benefits in the diagnosis and therapeutic management of adult glioma. This study examines the relationship between CBV, K^trans, and overall survival.

METHODS AND MATERIALS: Twenty-seven adult patients with glioma underwent T1-weighted dynamic contrast-enhanced MR imaging, and parametric maps of CBV and K^trans were calculated. The relationship of histologic grade, CBV, K^trans, age, sex, surgical resection, and use of adjuvant therapy to survival were analyzed by using the logrank method and Cox regression analysis. The Kaplan-Meier method for displaying survival curves was used. The relationship of factors such as comorbidity, elevated intracranial pressure, size of nonenhancing tumor, and peritumoral edema were not considered.

RESULTS: Both CBV (P < .01) and K^trans (P < .01) show a significant relationship to histologic grade. CBV (P = .004), K^trans (P = .008), and histologic grade (P < .001) all demonstrate a significant association with patient survival when analyzed individually. Cox regression analysis identified only histologic grade (P < .01) and K^trans (P < .05) as independent significant prognostic indicators. Examination of survival data from high-grade (III and IV) tumors demonstrated a linear relationship between K^trans and patient survival (P < .01).

CONCLUSION: This study suggests a direct relationship between K^trans and length of survival in high-grade gliomas, which could be of clinical importance. CBV relates directly to histologic grade but provides no independent prognostic information over and above that provided by grade. Further large prospective studies should be planned to test whether this observation holds true.

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