부산대학교 도서관

Introduction When evaluating MRIs for glioblastoma progression, previous scans are usually included into the review. Nowadays dynamic susceptibility contrast (DSC)-perfusion is an essential component in MR-diagnostics of gliomas, since the extent of hyperperfusion upon first diagnosis correlates with gene expression and survival. We aimed to investigate if this initial perfusion signature also characterizes the glioblastoma at time of progression. If so, DSC-perfusion data from the initial diagnosis could be of diagnostic benefit in follow-up assessments. Methods We retrospectively identified 65 patients with isocitrate dehydrogenase wildtype glioblastoma who had received technically identical DSC-perfusion measurements at initial diagnosis and at time of first progression. We determined maximum relative cerebral blood volume values (rCBV.sub.max) by standardized re-evaluation of the data including leakage correction. In addition, the corresponding tissue samples from 24 patients were examined histologically for the maximum vessel density within the tumor. Differences (paired t-test/ Wilcoxon matched pairs test) and correlations (Spearman) between the measurements at both timepoints were calculated. Results The rCBV.sub.max was consistently lower at time of progression compared to rCBV.sub.max at time of first diagnosis (p < .001). There was no correlation between the rCBV.sub.max values at both timepoints (r = .12). These findings were reflected in the histological examination, with a lower vessel density in progressive glioblastoma (p = .01) and no correlation between the two timepoints (r = -.07). Conclusion Our results suggest that the extent of hyperperfusion in glioblastoma at first diagnosis is not a sustaining tumor characteristic. Hence, the rCBV.sub.max at initial diagnosis should be disregarded when reviewing MRIs for glioblastoma progression.
Author(s): Eike Steidl 1,2,*, Katharina Filipski 2,3,4, Elke Hattingen 1,2,4, Joachim P. Steinbach 2,4,5, Gabriele D. Maurer 5 Introduction The revised Response Assessment in Neuro-oncology (RANO) criteria for the evaluation [...]