Survival prediction in high-grade gliomas using CT perfusion imaging

Area of Science:

• Neuro-oncology
• Medical imaging
• Radiology

Background:

• High-grade gliomas (WHO grades III and IV) exhibit heterogeneous responses to standard treatments like surgery and chemoirradiation.
• Predicting overall survival (OS) in these patients remains challenging.

Purpose of the Study:

• To evaluate serial changes in tumor volume and perfusion imaging parameters in high-grade glioma patients.
• To determine the predictive value of these imaging data for overall survival (OS).

Main Methods:

• Twenty-nine patients with WHO grades III and IV gliomas underwent serial MR and CT perfusion examinations.
• Analysis included receiver operating characteristic analysis, Cox regression, and Kaplan-Meier survival analysis.
• Evaluated parameters included blood flow (BF), blood volume (BV), and permeability-surface area product in contrast-enhancing lesions (CEL) and non-enhancing lesions (NEL).

Main Results:

• Higher trends in BF, BV, and permeability-surface area product were observed in patients with OS < 18 months compared to those with OS ≥ 18 months.
• CT perfusion parameters demonstrated ≥70% sensitivity and specificity for predicting 18- and 24-month OS.
• Pre-surgery BF (NEL) and 3-month post-radiotherapy BV (CEL and NEL) showed >80% sensitivity and specificity for predicting 24-month OS in grade IV gliomas.

Conclusions:

• CT perfusion parameters are valuable predictors of survival in high-grade gliomas.
• These parameters can aid in early response assessment and treatment selection to potentially prolong survival.
• Further validation in larger patient cohorts is recommended.