Perfusion predict time to progression in glioblastoma
Positive perfusion in surgical cavity wall enhancement (SCWE) may predict longer time to progression (TTP) in glioblastoma patients, a new study suggests.
The study included 60 glioblastoma patients receiving standard concurrent chemoradiation therapy (CCRT) after surgery. Exclusion criteria included magnetic resonance (MR) imaging performed more than 1 month after CCRT, no follow-up MR imaging and poor quality of arterial spin labelling (ASL) imaging.
Two readers independently assessed the SCWE for perfusions (positive or negative), contrast-enhancing lesions (presence or absence) and contrast enhancement pattern (nodular or non-nodular). Perfusion fraction was calculated by dividing areas of high perfusion by areas of contrast enhancement.
Univariate analysis showed that positive perfusion was significantly associated with longer TTP (hazard ratio [HR], 0.49; 95 percent CI, 0.25 to 0.96; p=0.04). Perfusion fraction with a higher volume was also associated with longer TTP for both reader 1 (HR, 0.98; 0.98 to 0.99; p=0.021) and 2 (HR, 0.98; 0.98 to 0.99; p=0.005).
Subsequent multivariable analysis showed that positive perfusion (HR, 0.33; 0.15 to 0.68; p=0.02) and a high perfusion fraction (HR, 0.97; 0.97 to 0.99; p=0.001 for reader 1 and HR, 0.98; 0.97 to 0.99; p<0.001 for reader 2) were both significant independent predictors of longer TTP.
Kaplan-Meier analysis showed that those with increased perfusion had significantly longer median TTP compared with those with decreased perfusion (29 vs 13 months; p=0.036).
Moreover, linear regression showed that perfusion fraction was significantly correlated with TTP for both readers (p<0.001 for both).