Prognosis prediction of measurable enhancing lesion after completion of standard concomitant chemoradiotherapy and adjuvant temozolomide in glioblastoma patients: Application of dynamic susceptibility contrast perfusion and diffusion-weighted imaging

Jae Hyun Kim, Seung Hong Choi, Inseon Ryoo, Tae Jin Yun, Tae Min Kim, Se Hoon Lee, Chul Kee Park, Ji Hoon Kim, Chul Ho Sohn, Sung Hye Park, Il Han Kim

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the prognosis predictability of a measurable enhancing lesion using histogram parameters produced by the normalized cerebral blood volume (nCBV) and normalized apparent diffusion coefficient (nADC) after completion of standard concomitant chemoradiotherapy (CCRT) and adjuvant temozolomide (TMZ) medication in glioblastoma multiforme (GBM) patients. Materials and Methods: This study was approved by the institutional review board (IRB), and the requirement for informed consent was waived. A total of 59 patients with newly diagnosed GBM who received standard CCRT with TMZ and adjuvant TMZ for six cycles underwent perfusion-weighted and diffusion-weighted imaging. Twenty-seven patients had a measurable enhancing lesion and 32 patients lacked a measurable enhancing lesion based on the Response Assessment in Neuro-Oncology (RANO) criteria in the follow-up MRI, which was performed within 3 months after adjuvant TMZ therapy was completed. We measured the nCBV and nADC histogram parameters based on the measurable enhancing lesion. The progression free survival (PFS) was analyzed by the Kaplan-Meier method with the use of the log-rank test. Results: The median PFS of patients lacking measurable enhancing lesion was longer than for those with measurable enhancing lesions (17.6 vs 3.3 months, P<.0001). There was a significant, positive correlation between the 99th percentile nCBV value of a measurable enhancing lesion and the PFS (P=.044, R2=.152). In addition, the median PFS was longer in patients with a 99th percentile nCBV value ≥4.5 than it was in those with a value <4.5 (4.4 vs 3.1 months, P=.036). Conclusion: We found that the nCBV value can be used for the prognosis prediction of a measurable enhancing lesion after the completion of standard treatment for GBM, wherein a high 99th percentile nCBV value (≥4.5) suggests a better PFS for GBM patients.

Original languageEnglish
Article numbere113587
JournalPLoS One
Volume9
Issue number11
DOIs
Publication statusPublished - 2014 Nov 24
Externally publishedYes

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temozolomide
Chemoradiotherapy
Glioblastoma
blood volume
prognosis
adjuvants
Blood
Perfusion
image analysis
Imaging techniques
Disease-Free Survival
prediction
diffusivity
Oncology
Research Ethics Committees
Magnetic resonance imaging
Informed Consent
drug therapy
Cerebral Blood Volume

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Prognosis prediction of measurable enhancing lesion after completion of standard concomitant chemoradiotherapy and adjuvant temozolomide in glioblastoma patients : Application of dynamic susceptibility contrast perfusion and diffusion-weighted imaging. / Kim, Jae Hyun; Choi, Seung Hong; Ryoo, Inseon; Yun, Tae Jin; Kim, Tae Min; Lee, Se Hoon; Park, Chul Kee; Kim, Ji Hoon; Sohn, Chul Ho; Park, Sung Hye; Kim, Il Han.

In: PLoS One, Vol. 9, No. 11, e113587, 24.11.2014.

Research output: Contribution to journalArticle

Kim, Jae Hyun ; Choi, Seung Hong ; Ryoo, Inseon ; Yun, Tae Jin ; Kim, Tae Min ; Lee, Se Hoon ; Park, Chul Kee ; Kim, Ji Hoon ; Sohn, Chul Ho ; Park, Sung Hye ; Kim, Il Han. / Prognosis prediction of measurable enhancing lesion after completion of standard concomitant chemoradiotherapy and adjuvant temozolomide in glioblastoma patients : Application of dynamic susceptibility contrast perfusion and diffusion-weighted imaging. In: PLoS One. 2014 ; Vol. 9, No. 11.
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abstract = "Purpose: To assess the prognosis predictability of a measurable enhancing lesion using histogram parameters produced by the normalized cerebral blood volume (nCBV) and normalized apparent diffusion coefficient (nADC) after completion of standard concomitant chemoradiotherapy (CCRT) and adjuvant temozolomide (TMZ) medication in glioblastoma multiforme (GBM) patients. Materials and Methods: This study was approved by the institutional review board (IRB), and the requirement for informed consent was waived. A total of 59 patients with newly diagnosed GBM who received standard CCRT with TMZ and adjuvant TMZ for six cycles underwent perfusion-weighted and diffusion-weighted imaging. Twenty-seven patients had a measurable enhancing lesion and 32 patients lacked a measurable enhancing lesion based on the Response Assessment in Neuro-Oncology (RANO) criteria in the follow-up MRI, which was performed within 3 months after adjuvant TMZ therapy was completed. We measured the nCBV and nADC histogram parameters based on the measurable enhancing lesion. The progression free survival (PFS) was analyzed by the Kaplan-Meier method with the use of the log-rank test. Results: The median PFS of patients lacking measurable enhancing lesion was longer than for those with measurable enhancing lesions (17.6 vs 3.3 months, P<.0001). There was a significant, positive correlation between the 99th percentile nCBV value of a measurable enhancing lesion and the PFS (P=.044, R2=.152). In addition, the median PFS was longer in patients with a 99th percentile nCBV value ≥4.5 than it was in those with a value <4.5 (4.4 vs 3.1 months, P=.036). Conclusion: We found that the nCBV value can be used for the prognosis prediction of a measurable enhancing lesion after the completion of standard treatment for GBM, wherein a high 99th percentile nCBV value (≥4.5) suggests a better PFS for GBM patients.",
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T1 - Prognosis prediction of measurable enhancing lesion after completion of standard concomitant chemoradiotherapy and adjuvant temozolomide in glioblastoma patients

T2 - Application of dynamic susceptibility contrast perfusion and diffusion-weighted imaging

AU - Kim, Jae Hyun

AU - Choi, Seung Hong

AU - Ryoo, Inseon

AU - Yun, Tae Jin

AU - Kim, Tae Min

AU - Lee, Se Hoon

AU - Park, Chul Kee

AU - Kim, Ji Hoon

AU - Sohn, Chul Ho

AU - Park, Sung Hye

AU - Kim, Il Han

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N2 - Purpose: To assess the prognosis predictability of a measurable enhancing lesion using histogram parameters produced by the normalized cerebral blood volume (nCBV) and normalized apparent diffusion coefficient (nADC) after completion of standard concomitant chemoradiotherapy (CCRT) and adjuvant temozolomide (TMZ) medication in glioblastoma multiforme (GBM) patients. Materials and Methods: This study was approved by the institutional review board (IRB), and the requirement for informed consent was waived. A total of 59 patients with newly diagnosed GBM who received standard CCRT with TMZ and adjuvant TMZ for six cycles underwent perfusion-weighted and diffusion-weighted imaging. Twenty-seven patients had a measurable enhancing lesion and 32 patients lacked a measurable enhancing lesion based on the Response Assessment in Neuro-Oncology (RANO) criteria in the follow-up MRI, which was performed within 3 months after adjuvant TMZ therapy was completed. We measured the nCBV and nADC histogram parameters based on the measurable enhancing lesion. The progression free survival (PFS) was analyzed by the Kaplan-Meier method with the use of the log-rank test. Results: The median PFS of patients lacking measurable enhancing lesion was longer than for those with measurable enhancing lesions (17.6 vs 3.3 months, P<.0001). There was a significant, positive correlation between the 99th percentile nCBV value of a measurable enhancing lesion and the PFS (P=.044, R2=.152). In addition, the median PFS was longer in patients with a 99th percentile nCBV value ≥4.5 than it was in those with a value <4.5 (4.4 vs 3.1 months, P=.036). Conclusion: We found that the nCBV value can be used for the prognosis prediction of a measurable enhancing lesion after the completion of standard treatment for GBM, wherein a high 99th percentile nCBV value (≥4.5) suggests a better PFS for GBM patients.

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