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Association of dynamic susceptibility contrast enhanced MR Perfusion parameters with prognosis in elderly patients
Pejman Jabehdar Maralani1, Elias R Melhem, Sumei Wang
1Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada, pejman.maralani@sunnybrook.ca.
Objectives:
We aimed to evaluate the prognostic value of dynamic susceptibility contrast (DSC) MR perfusion in elderly patients with glioblastomas (GBM).
Methods:
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.
Results:
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).
Conclusion:
rCBV can be an imaging biomarker to identify a subgroup of GBM patients in the elderly with worse prognosis compared to others.
Key Points:
• 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.
