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Dynamic susceptibility contrast MRI measures of relative cerebral blood volume as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 multicenter trial. Neuro Oncol 2015 Aug;17(8):1148-56 PMID: 25646027 PMCID: PMC4490871

Pubmed ID

25646027

Abstract

BACKGROUND: The study goal was to determine whether changes in relative cerebral blood volume (rCBV) derived from dynamic susceptibility contrast (DSC) MRI are predictive of overall survival (OS) in patients with recurrent glioblastoma multiforme (GBM) when measured 2, 8, and 16 weeks after treatment initiation.

METHODS: Patients with recurrent GBM (37/123) enrolled in ACRIN 6677/RTOG 0625, a multicenter, randomized, phase II trial of bevacizumab with irinotecan or temozolomide, consented to DSC-MRI plus conventional MRI, 21 with DSC-MRI at baseline and at least 1 postbaseline scan. Contrast-enhancing regions of interest were determined semi-automatically using pre- and postcontrast T1-weighted images. Mean tumor rCBV normalized to white matter (nRCBV) and standardized rCBV (sRCBV) were determined for these regions of interest. The OS rates for patients with positive versus negative changes from baseline in nRCBV and sRCBV were compared using Wilcoxon rank-sum and Kaplan-Meier survival estimates with log-rank tests.

RESULTS: Patients surviving at least 1 year (OS-1) had significantly larger decreases in nRCBV at week 2 (P = .0451) and sRCBV at week 16 (P = .014). Receiver operating characteristic analysis found the percent changes of nRCBV and sRCBV at week 2 and sRCBV at week 16, but not rCBV data at week 8, to be good prognostic markers for OS-1. Patients with positive change from baseline rCBV had significantly shorter OS than those with negative change at both week 2 and week 16 (P = .0015 and P = .0067 for nRCBV and P = .0251 and P = .0004 for sRCBV, respectively).

CONCLUSIONS: Early decreases in rCBV are predictive of improved survival in patients with recurrent GBM treated with bevacizumab.

Author List

Schmainda KM, Zhang Z, Prah M, Snyder BS, Gilbert MR, Sorensen AG, Barboriak DP, Boxerman JL

Author

Kathleen M. Schmainda PhD Professor in the Radiology department at Medical College of Wisconsin




Scopus

2-s2.0-84931849773   28 Citations

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Angiogenesis Inhibitors
Antineoplastic Agents, Alkylating
Antineoplastic Agents, Phytogenic
Bevacizumab
Brain Neoplasms
Camptothecin
Cerebral Cortex
Contrast Media
Dacarbazine
Female
Glioblastoma
Humans
Kaplan-Meier Estimate
Magnetic Resonance Imaging
Male
Middle Aged
Prognosis
Treatment Outcome
Young Adult
jenkins-FCD Prod-256 97250b83e4554f37bec91ca291f44ff4aedcc508