Haney S, Thompson PM, Cloughesy TF, Alger JR, Frew AJ, Toga AW
Laboratory of Neuro Imaging, Department of Neurology, Division of
Neuro-Oncology Program, The Henry E. Singleton Brain Cancer Research Program;
Dept. of Radiological Sciences; UCLA School of Medicine, Los Angeles, CA 90095
Prognostic factors provide information to the physician and patient and may help guide therapy decisions. We set out to determine imaging measures that best predicted survival time in a group of glioblastoma multiforme (GBM) patients. As part of a longitudinal study in patients with malignant gliomas, 15 patients with histopathologically confirmed diagnosis of GBM, were serially scanned. T2-weighted and T1-weighted gadolinium-enhanced SPGR (spoiled GRASS) MRI volumes as well as 3D [1H]-MR spectroscopic data were acquired. Volumetric data for tumor, as represented by contrast-enhancing tissue, and edema were determined by both manual and automated segmentation. CHO/CRE (choline/creatine) ratios were determined from spectroscopic analysis. Growth rates were determined from change in volumetric measures of contrast-enhancing tissue. A multivariate analysis of factors including total survival time, age, growth rates for contrast-enhancing tissue, and CHO/CRE ratio was performed.
In addition, short-interval MR scanning (15 scans in 104 days) was performed on a GBM patient. Following a therapy modification, a cessation of growth in contrast enhancing tissue was noted. In the larger cohort of patients, growth rates were significantly correlated with survival (p<0.03). Age, a well-known predictor of survival, was negatively correlated with survival (r=-0.5; p<0.02). CHO/CRE measures were also significantly correlated with survival (p<0.02).
Growth rates provide an important marker which is significantly related to survival. As a dynamic imaging marker, growth rates provide information regarding the changing state of the tumor, which may be used in therapy decision making. Further, the insight gained by repeated short-interval scanning will be discussed.
Grant Support: (to PT/AWT): NIMH/NIDA (P20 MH/DA52176); P41 NCRR (RR13642);NLM (LM/MHO5639), NSF (BIR 93-22434), NCRR (RR05956) and NINDS/NIMH (NS38753).
Paul Thompson, Ph.D.
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