Macrovascular Networks on Contrast-Enhanced Magnetic Resonance Imaging Improves Survival Prediction in Newly Diagnosed Glioblastoma
dc.contributor.author
dc.date.accessioned
2019-09-05T07:27:31Z
dc.date.available
2019-09-05T07:27:31Z
dc.date.issued
2019-01-14
dc.identifier.uri
dc.description.abstract
A higher degree of angiogenesis is associated with shortened survival in glioblastoma.
Feasible morphometric parameters for analyzing vascular networks in brain tumors in clinical
practice are lacking. We investigated whether the macrovascular network classified by the number of
vessel-like structures (nVS) visible on three-dimensional T1-weighted contrast–enhanced (3D-T1CE)
magnetic resonance imaging (MRI) could improve survival prediction models for newly diagnosed
glioblastoma based on clinical and other imaging features. Ninety-seven consecutive patients (62 men;
mean age, 58 ± 15 years) with histologically proven glioblastoma underwent 1.5T-MRI, including
anatomical, diffusion-weighted, dynamic susceptibility contrast perfusion, and 3D-T1CE sequences
after 0.1 mmol/kg gadobutrol. We assessed nVS related to the tumor on 1-mm isovoxel 3D-T1CE
images, and relative cerebral blood volume, relative cerebral flow volume (rCBF), delay mean time,
and apparent diffusion coefficient in volumes of interest for contrast-enhancing lesion (CEL), non-CEL,
and contralateral normal-appearing white matter. We also assessed Visually Accessible Rembrandt Images scoring system features. We used ROC curves to determine the cutoff for nVS and univariate
and multivariate cox proportional hazards regression for overall survival. Prognostic factors were
evaluated by Kaplan-Meier survival and ROC analyses. Lesions with nVS > 5 were classified as having
highly developed macrovascular network; 58 (60.4%) tumors had highly developed macrovascular
network. Patients with highly developed macrovascular network were older, had higher volumeCEL,
increased rCBFCEL, and poor survival; nVS correlated negatively with survival (r = −0.286; p = 0.008).
On multivariate analysis, standard treatment, age at diagnosis, and macrovascular network best
predicted survival at 1 year (AUC 0.901, 83.3% sensitivity, 93.3% specificity, 96.2% PPV, 73.7%
NPV). Contrast-enhanced MRI macrovascular network improves survival prediction in newly
diagnosed glioblastoma
dc.description.sponsorship
This research was funded by “Fundació La Marató TV3” (665/C/2013)
dc.format.mimetype
application/pdf
dc.language.iso
eng
dc.publisher
MDPI (Multidisciplinary Digital Publishing Institute)
dc.relation.isformatof
Reproducció digital del document publicat a: https://doi.org/10.3390/cancers11010084
dc.relation.ispartof
Cancers, 2019, vol. 11, núm. 1, p. 84
dc.relation.ispartofseries
Articles publicats (D-IMA)
dc.rights
Attribution 4.0 International
dc.rights.uri
dc.subject
dc.title
Macrovascular Networks on Contrast-Enhanced Magnetic Resonance Imaging Improves Survival Prediction in Newly Diagnosed Glioblastoma
dc.type
info:eu-repo/semantics/article
dc.rights.accessRights
info:eu-repo/semantics/openAccess
dc.type.version
info:eu-repo/semantics/publishedVersion
dc.identifier.doi
dc.identifier.idgrec
029437
dc.type.peerreviewed
peer-reviewed
dc.identifier.eissn
2072-6694