TY - JOUR
T1 - Impact of perfusion map analysis on early survival prediction accuracy in glioma patients
AU - Lemasson, Benjamin
AU - Chenevert, Thomas L.
AU - Lawrence, Theodore S.
AU - Tsien, Christina
AU - Sundgren, Pia C.
AU - Meyer, Charles R.
AU - Junck, Larry
AU - Boes, Jennifer
AU - Galbán, Stefanie
AU - Johnson, Timothy D.
AU - Rehemtulla, Alnawaz
AU - Ross, Brian D.
AU - Galbán, Craig J.
N1 - Funding Information:
Address all correspondence to: Craig J. Galbán, PhD, Assistant Professor of Radiology, Center for Molecular Imaging, University of Michigan, Biomedical Sciences Research Building, Room D200, 109 Zina Pitcher Place, Ann Arbor, MI 48109-2200. E-mail: cgalban@umich.edu 1This work was supported by the US National Institutes of Health research grants P01CA085878, U01CA166104, and P01CA087634. B.D.R. and A.R. have ownership interest (including patents) from Imbio, LLC. B.D.R., A.R., T.L.C., and C.J.G. have a financial interest in the underlying voxel-based technology. The other authors disclosed no potential conflicts of interest. Received 21 October 2013; Revised 21 October 2013; Accepted 28 October 2013 Copyright © 2013 Neoplasia Press, Inc. Open access under CC BY-NC-ND license. 1944-7124/13 DOI 10.1593/tlo.13670
PY - 2013/12
Y1 - 2013/12
N2 - Studies investigating dynamic susceptibility contrast magnetic resonance imaging-determined relative cerebral blood volume (rCBV) maps as a metric of treatment response assessment have generated conflicting results. We evaluated the potential of various analytical techniques to predict survival of patients with glioma treated with chemoradiation. rCBV maps were acquired in patients with high-grade gliomas at 0, 1, and 3 weeks into chemoradiation therapy. Various analytical techniques were applied to the same cohort of serial rCBV data for early assessment of survival. Three different methodologies were investigated: 1) percentage change of whole tumor statistics (i.e., mean, median, and percentiles), 2) physiological segmentation (low rCBV, medium rCBV, or high rCBV), and 3) a voxel-based approach, parametric response mapping (PRM). All analyses were performed using the same tumor contours, which were determined using contrast-enhanced T1-weighted and fluid attenuated inversion recovery images. The predictive potential of each response metric was assessed at 1-year and overall survival. PRM was the only analytical approach found to generate a response metric significantly predictive of patient 1-year survival. Time of acquisition and contour volume were not found to alter the sensitivity of the PRM approach for predicting overall survival. We have demonstrated the importance of the analytical approach in early response assessment using serial rCBV maps. The PRM analysis shows promise as a unified early and robust imaging biomarker of treatment response in patients diagnosed with high-grade gliomas.
AB - Studies investigating dynamic susceptibility contrast magnetic resonance imaging-determined relative cerebral blood volume (rCBV) maps as a metric of treatment response assessment have generated conflicting results. We evaluated the potential of various analytical techniques to predict survival of patients with glioma treated with chemoradiation. rCBV maps were acquired in patients with high-grade gliomas at 0, 1, and 3 weeks into chemoradiation therapy. Various analytical techniques were applied to the same cohort of serial rCBV data for early assessment of survival. Three different methodologies were investigated: 1) percentage change of whole tumor statistics (i.e., mean, median, and percentiles), 2) physiological segmentation (low rCBV, medium rCBV, or high rCBV), and 3) a voxel-based approach, parametric response mapping (PRM). All analyses were performed using the same tumor contours, which were determined using contrast-enhanced T1-weighted and fluid attenuated inversion recovery images. The predictive potential of each response metric was assessed at 1-year and overall survival. PRM was the only analytical approach found to generate a response metric significantly predictive of patient 1-year survival. Time of acquisition and contour volume were not found to alter the sensitivity of the PRM approach for predicting overall survival. We have demonstrated the importance of the analytical approach in early response assessment using serial rCBV maps. The PRM analysis shows promise as a unified early and robust imaging biomarker of treatment response in patients diagnosed with high-grade gliomas.
UR - http://www.scopus.com/inward/record.url?scp=84891677854&partnerID=8YFLogxK
U2 - 10.1593/tlo.13670
DO - 10.1593/tlo.13670
M3 - Article
C2 - 24466380
AN - SCOPUS:84891677854
SN - 1936-5233
VL - 6
SP - 766
EP - 774
JO - Translational Oncology
JF - Translational Oncology
IS - 6
ER -