Glioblastoma: A method for predicting response to antiangiogenic chemotherapy by using MR perfusion imaging - Pilot study

Rahul N. Sawlani, Jeffrey Raizer, Sandra W. Horowitz, Wanyong Shin, Sean A. Grimm, James P. Chandler, Robert Levy, Christopher Getch, Timothy J. Carroll

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

Purpose: To derive a magnetic resonance (MR)-based imaging metric that reflects local perfusion changes resulting from the administration of angiogenic-inhibiting chemotherapy in patients with recurrent glioblastoma multiforme (GBM). Materials and Methods: In this retrospective Institutional Review Board-approved HIPAA-compliant study, 16 patients (12 men, four women; mean age, 51.8 years ± 15.1 [standard deviation]) with recurrent GBM received bevacizumab every 3 weeks (15 mg per kilogram of body weight) as part of a clinical trial. Baseline MR images were acquired, and follow-up images were acquired every 6 weeks thereafter until tumor progression or death. Imaging included perfusion and T1-weighted contrast material-enhanced MR imaging. Perfusion images were analyzed both with and without correction for contrast material leakage. The volumes of interest were selected as enhancing voxels on T1-weighted contrast-enhanced MR images. Relative cerebral blood volume (rCBV) maps were created from analysis of MR perfusion images. The volumes of interest were used to calculate the following parameters: size, mean rCBV, mean leakage coefficient K2. and hyperperfusion volume (HPV), which is the fraction of the tumor with an rCBV higher than a predetermined threshold. Percent change in each parameter from baseline to first follow-up was compared with time to progression (TTP) by using a Cox proportional hazards model with calculation of hazard ratios. Results: The most significant hazard ratio was seen with a D HPV cutoff of rCBV greater than 1.00 (hazard ratio, 1.077; 95% confidence interval: 1.026, 1.130; P = .002). The only significant ratios greater than one were those that resulted from perfusion calculated as mean rCBV and D HPV. The ratios were also higher after correction for leakage. Conclusion: This pilot study derived an imaging metric (HPV) that reflects local perfusion changes in GBMs. This metric was found to show a significantly improved correlation to TTP as compared with more commonly used metrics.

Original languageEnglish (US)
Pages (from-to)622-628
Number of pages7
JournalRadiology
Volume255
Issue number2
DOIs
StatePublished - May 2010

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Sawlani, R. N., Raizer, J., Horowitz, S. W., Shin, W., Grimm, S. A., Chandler, J. P., Levy, R., Getch, C., & Carroll, T. J. (2010). Glioblastoma: A method for predicting response to antiangiogenic chemotherapy by using MR perfusion imaging - Pilot study. Radiology, 255(2), 622-628. https://doi.org/10.1148/radiol.10091341