Prognostic value of perfusion MR imaging of high-grade astrocytomas: Long-term follow-up study

被引:115
|
作者
Hirai, T. [1 ]
Murakami, R. [2 ]
Nakamura, H. [3 ]
Kitajima, M. [1 ]
Fukuoka, H. [1 ]
Sasao, A. [1 ]
Akter, M. [1 ]
Hayashida, Y. [1 ]
Toya, R. [2 ]
Oya, N. [2 ]
Awa, K. [1 ]
Lyama, K. [4 ]
Kuratsu, J. -i. [3 ]
Yamashita, Y. [1 ]
机构
[1] Kumamoto Univ, Dept Diagnost Radiol, Grad Sch Med Sci, Kumamoto 8608556, Japan
[2] Kumamoto Univ, Dept Radiat Oncol, Grad Sch Med Sci, Kumamoto 8608556, Japan
[3] Kumamoto Univ, Dept Neurosurg, Grad Sch Med Sci, Kumamoto 8608556, Japan
[4] Kumamoto Univ, Dept Pathol, Grad Sch Med Sci, Kumamoto 8608556, Japan
关键词
D O I
10.3174/ajnr.A1121
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: Although the prognostic value of perfusion MR imaging in various gliomas has been investigated, that in high-grade astrocytomas alone has not been fully evaluated. The purpose of this study was to evaluate retrospectively whether the tumor maximum relative cerebral blood volume (rCBV) on pretreatment perfusion MR imaging is of prognostic value in patients with high-grade astrocytoma. MATERIALS AND METHODS: Between January 1999 and December 2002, 49 patients (30 men, 19 women; age range, 23-76 years) with supratentorial high-grade astrocytoma underwent MR imaging before the inception of treatment. The patient age, sex, symptom duration, neurologic function, mental status, Karnofsky Performance Scale, extent of surgery, histopathologic diagnosis, tumor component enhancement, and maximum rCBV were assessed to identify factors affecting survival. Kaplan-Meier survival curves, the logrank test, and the multivariate Cox proportional hazards model were used to evaluate prognostic factors. RESULTS: The maximum rCBV was significantly higher in the 31 patients with glioblastoma multiforme than in the 18 with anaplastic astrocytoma (P < .03). The 2-year overall survival rate was 67% for 27 patients with a low (<= 2.3) and 9% for 22 patients with a high (> 2.3) maximum rCBV value (P < .001). Independent important prognostic factors were the histologic diagnosis (hazard ratio = 9.707; 95% confidence interval (CI), 3.163-29.788), maximum rCBV (4.739; 95% CI, 1.950-11.518), extent of surgery (2.692; 95% CI, 1.196-6.061), and sex (2.632; 95% CI, 1.153-6.010). CONCLUSION: The maximum rCBV at pretreatment perfusion MR imaging is a useful clinical prognostic biomarker for survival in patients with high-grade astrocytoma.
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页码:1505 / 1510
页数:6
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