Jabehdar Maralani Pejman, Melhem Elias R, Wang Sumei, Herskovits Edward H, Voluck Matthew R, Kim Sang Joon, Learned Kim O, O'Rourke Donald M, Mohan Suyash
Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada,
Eur Radiol. 2015 Sep;25(9):2738-44. doi: 10.1007/s00330-015-3640-4. Epub 2015 Feb 14.
We aimed to evaluate the prognostic value of dynamic susceptibility contrast (DSC) MR perfusion in elderly patients with glioblastomas (GBM).
Thirty five patients aged ≥65 and 35 aged <65 years old, (referred to as elderly and younger, respectively) were included in this retrospective study. The median relative cerebral volume (rCBV) from the enhancing region (rCBVER-Med) and immediate peritumoral region (rCBVIPR-Med) and maximum rCBV from the enhancing region of the tumor (rCBVER-Max) were compared and correlated with survival data. Analysis was repeated after rCBVs were dichotomized into high and low values and after excluding elderly patients who did not receive postoperative chemoradiation (34.3%). Kaplan-Meyer survival curves and parametric and semi-parametric regression tests were used for analysis.
All rCBV parameters were higher in elderly compared to younger patients (p < 0.05). After adjustment for age, none were independently associated with shorter survival (p > 0.05). After rCBV dichotomization into high and low values, high rCBV in elderly was independently associated with shorter survival compared to low rCBV in elderly, or any rCBV in younger patients (p < 0.05).
rCBV can be an imaging biomarker to identify a subgroup of GBM patients in the elderly with worse prognosis compared to others.
• GBM perfusion parameters are higher in elderly compared to younger patients. • rCBV can identify a subgroup of elderly patients with worse prognosis. • rCBV can be an imaging biomarker for prognostication in GBM. • The identified elderly patients may benefit from anti-angiogenic treatment.
我们旨在评估动态磁敏感对比增强（DSC）磁共振灌注成像在老年胶质母细胞瘤（GBM）患者中的预后价值。
本回顾性研究纳入了35例年龄≥65岁（分别称为老年组）和35例年龄<65岁（分别称为年轻组）的患者。比较了肿瘤强化区域（rCBVER-Med）和紧邻肿瘤周围区域（rCBVIPR-Med）的中位相对脑血容量（rCBV）以及肿瘤强化区域的最大rCBV（rCBVER-Max），并将其与生存数据进行关联分析。在将rCBV分为高值和低值后，以及在排除未接受术后放化疗的老年患者（34.3%）后，重复进行分析。采用Kaplan-Meier生存曲线以及参数和半参数回归检验进行分析。
与年轻患者相比，老年患者的所有rCBV参数均更高（p < 0.05）。在对年龄进行校正后，这些参数均与较短生存期无独立相关性（p > 0.05）。在将rCBV分为高值和低值后，与老年患者中的低值rCBV或年轻患者中的任何rCBV相比，老年患者中的高rCBV与较短生存期独立相关（p < 0.05）。
rCBV可作为一种影像学生物标志物，用于识别老年GBM患者中预后较差的亚组。
• 与年轻患者相比，老年GBM患者的灌注参数更高。• rCBV可识别预后较差的老年患者亚组。• rCBV可作为GBM预后评估的影像学生物标志物。• 所识别出的老年患者可能从抗血管生成治疗中获益。
