PT - JOURNAL ARTICLE AU - I. Hwang AU - S.H. Choi AU - C.-K. Park AU - T.M. Kim AU - S.-H. Park AU - J.K. Won AU - I.H. Kim AU - S.-T. Lee AU - R.-E. Yoo AU - K.M. Kang AU - T.J. Yun AU - J.-H. Kim AU - C.-H. Sohn TI - Dynamic Contrast-Enhanced MR Imaging of Nonenhancing T2 High-Signal-Intensity Lesions in Baseline and Posttreatment Glioblastoma: Temporal Change and Prognostic Value AID - 10.3174/ajnr.A6323 DP - 2020 Jan 01 TA - American Journal of Neuroradiology PG - 49--56 VI - 41 IP - 1 4099 - http://www.ajnr.org/content/41/1/49.short 4100 - http://www.ajnr.org/content/41/1/49.full SO - Am. J. Neuroradiol.2020 Jan 01; 41 AB - BACKGROUND AND PURPOSE: The prognostic value of dynamic contrast-enhanced MR imaging on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma has not been thoroughly elucidated to date. We evaluated the temporal change and prognostic value for progression-free survival of dynamic contrast-enhanced MR imaging–derived pharmacokinetic parameters on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma before and after standard treatment, including gross total surgical resection.MATERIALS AND METHODS: This retrospective study included 33 patients who were newly diagnosed with glioblastoma and treated with gross total surgical resection followed by concurrent chemoradiation therapy and adjuvant chemotherapy with temozolomide in a single institution. All patients underwent dynamic contrast-enhanced MR imaging before surgery as a baseline and after completion of maximal surgical resection and concurrent chemoradiation therapy. On the whole nonenhancing T2 high-signal-intensity lesion, dynamic contrast-enhanced MR imaging–derived pharmacokinetic parameters (volume transfer constant [Ktrans], volume of extravascular extracellular space [ve], and blood plasma volume [vp]) were calculated. The Cox proportional hazards regression model analysis was performed to determine the histogram features or percentage changes of pharmacokinetic parameters related to progression-free survival.RESULTS: Baseline median Ktrans, baseline first quartile Ktrans, and posttreatment median Ktrans were significant independent variables, as determined by univariate analysis (P < .05). By multivariate Cox regression analysis including methylation status of O6-methylguanine-DNA methyltransferase, baseline median Ktrans was determined to be the significant independent variable and was negatively related to progression-free survival (hazard ratio = 1.48, P = .003).CONCLUSIONS: Baseline median Ktrans from nonenhancing T2 high-signal-intensity lesions could be a potential prognostic imaging biomarker in patients undergoing gross total surgical resection followed by standard therapy for glioblastoma.CCRTconcurrent chemoradiation therapyDCEdynamic contrast-enhancedKtransvolume transfer constantMGMTO6-methylguanine-DNA methyltransferasePFSprogression-free survivalTMZtemozolomidevevolume of extravascular extracellular spacevpblood plasma volume