Article Figures & Data
Figures
- Fig 1.
Source dynamic MR image (A), signal intensity time curves (S) (B), and color-coded perfusion map (overlaid on the corresponding FLAIR image) (C) of a male patient with a supratentorial astrocytoma (WHO grade III) in the left hemisphere (patient 21). The tumor pixel with the highest CBV value is represented as a small blue cross (L10). The contralateral corresponding white matter pixel is a purple cross (L16). The 2 pixels have distinct signal intensity curves with markedly deeper signal intensity drop in the tumor pixel (which begins 24 seconds after perfusion-weighted MR imaging initiation).
- Fig 2.
Scatterplot of the PFS and rCBVmax of the astrocytoma population. The plot presents the 2 population subgroups: the recurrent (solid triangles) and the nonrecurrent (open circles) astrocytomas. Note the high perfusion values of the recurrent tumors combined with shorter survival.
- Fig 3.
The ROC curves analyzing the sensitivity and specificity of rCBVmax values in astrocytomas for 1-year survival (A) and recurrence (B) show the optimal threshold value as ≤3.8 (sensitivity, 93.7% [95% confidence interval (CI), 69.7–99%]; specificity, 72.7% [95% CI, 39.1–93.7%], P = .0002) for 1-year survival and as >4.2 (sensitivity, 77.8% [95% CI, 40–96.5%]; specificity, 94.4% [72.6–99.1%], P = .0001) for recurrence. C, Kaplan-Meier curve of PFS probability (hazard ratio [HR] = 0.09, P = .0007). The thresholdmax represents the rCBVmax cutoff value, in which 1 corresponds to rCBVmax ≤4.2.
- Fig 4.
A and B, The ROC curves analyzing the sensitivity and specificity of the WHO grading system (I-IV) for the 1-year survival (A) and recurrence (B) show the optimal threshold value as <2 (WHO grade II) (sensitivity, 81.2% [95% confidence interval (CI), 54.3–95.7%]; specificity, 90.9% [95% CI, 58.7–98.5%], P = .0002) for 1-year survival and as >2 (sensitivity, 88.9% [95% CI, 51.7–98.2%]; specificity, 72.2% [95% CI, 46.5–90.2%], P = .0001) for recurrence. C, Kaplan-Meier curve of PFS probability is based on stratification according to the WHO grade (1 = low grade [WHO I-II], 2 = high grade [WHO III and IV)]; HR = 0.15, P = .05).
Tables
- Table 1:
Patient population demographics, histologic diagnosis with WHO grade, KPS, PFS, and maximum rCBV values
Patient Age (yr) Sex Pathology WHO KPS PFS (days) rCBVmax 1 26 M Astro 2 100 298 1.1 2 64 F Astro 4 70 99 9.1 3 61 M Astro 4 80 191 4.7 4 43 F Astro 1 90 668 2.1 5 45 M Astro 2 100 485 2.1 6 69 F Astro 4 60 749 3.5 7 79 M Astro 2 60 210 3.0 8 37 M Astro 2 50 117 4.8 9 56 F Astro 4 100 1521 1.9 10 19 F Astro 1 90 975 1.8 11 46 M Oligoastro 2 80 1041 1.2 12 56 F Oligoastro 2 90 1402 6.2 13 43 M Astro 2 100 428 6.1 14 49 M Astro 4 60 134 4.2 15 53 F Astro 2 90 1608 2.9 16 41 M Oligoastro 3 100 791 1.2 17 19 M Astro 3 90 1323 2.7 18 20 M Astro 1 80 392 3.8 19 31 M Astro 1 70 1831 1.2 20 37 M Astro 3 90 693 6.2 21 30 F Astro 3 90 567 1.2 22 16 F Oligodendro 3 70 1302 2.2 23 40 M Oligodendro 2 80 546 1.1 24 37 F Oligodendro 2 100 1540 5.6 25 43 F Oligodendro 2 100 380 4.1 26 68 F Astro 3 80 57 7.8 27 61 M Astro 4 50 85 11 28 81 M Astro 4 70 28 8.0 29 38 F Astro 2 80 546 1.0 30 53 M Astro 4 100 76 4.4 31 51 M Astro 2 90 386 1.1 32 41 M Astro 3 100 334 1.5 33 41 F Astro 2 80 911 1.3 34 46 M Astro 2 90 699 2.4 Note:—Astro indicates astrocytoma; oligoastro, oligoastrocytoma; oligodendro, oligodendroglioma; KPS, Kornofsky performance score; PFS, progression-free survival; rCBV, relative cerebral blood volume.
- Table 2:
Summary statistics of mean and maximum rCBV values, KPS, and PFS of the 3 subgroups of the patient population
rCBVmean rCBVmax KPS, Median (range) PFS (average in days) Astrocytomas (n = 27) 3.5 (±2.7) 3.7 (±2.7) 90 (50–100) 576 (±505) Oligodendrogliomas (n = 4) 3.1 (±2.2) 3.3 (±2.0) 90 (70–100) 942 (±566) Oligoastrocytomas (n= 3) 2.4 (±1.7) 2.9 (±2.3) 90 (70–90) 1030 (±401)
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