Related Experiment Videos
Correlation between dynamic MRI and outcome in patients with malignant gliomas
E T Wong1, E F Jackson, K R Hess
1Department of Neuro-Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, USA.
Abstract:
We assessed the correlation between dynamic MRI results and clinical outcomes in patients with malignant gliomas. Rapid serial MRIs were obtained after bolus injection of gadolinium that resulted in an initial fast uptake followed by a slow uptake of contrast. The maximum rate of uptake and delayed rate of uptake were correlated with survival and prognostic covariates such as age and histology. In 121 subjects, higher maximum uptake rates, 3.6 signal intensity units per second or greater, were associated with shorter survival (p = 0.0066). The correlation of delayed rate of uptake with survival was less significant. After adjusting for age, histology, and Karnofsky performance score, the maximum rate of uptake remained more significantly correlated with survival than the delayed rate of uptake. Thirty-one patients had surgery within 1 month of dynamic MRI, and those with glioblastoma multiforme or anaplastic gliomas had higher maximum rates of uptake than those with pure necrosis or mixed tumor and necrosis (p = 0.022). No correlation between delayed rate of uptake and histology was seen in this group of patients. Our results suggest that the maximum rate of uptake in dynamic MRI can be a prognostic measure for patients with malignant gliomas. Further prospective study is needed to assess the utility of this technique for evaluating brain tumors.
Insights
Dynamic MRI reveals that a faster maximum contrast uptake rate in malignant gliomas correlates with shorter survival. This uptake rate shows promise as a prognostic tool for brain tumor evaluation.
Area of Science:
- Neuro-oncology
- Radiology
- Medical Imaging
Background:
- Malignant gliomas are aggressive brain tumors with variable prognoses.
- Accurate prognostic markers are crucial for guiding treatment decisions.
- Dynamic MRI offers potential for non-invasive tumor characterization.
Purpose of the Study:
- To evaluate the correlation between dynamic MRI contrast uptake parameters and clinical outcomes in patients with malignant gliomas.
- To determine if dynamic MRI can serve as a prognostic indicator for survival.
- To assess the relationship between contrast uptake and tumor histology.
Main Methods:
- Rapid serial dynamic MRI scans were performed post-gadolinium injection in 121 patients.
- Analyzed maximum and delayed rates of contrast uptake.
- Correlated these uptake rates with patient survival, age, histology, and Karnofsky performance score.
Main Results:
- Higher maximum contrast uptake rates (≥3.6 signal intensity units/sec) were significantly associated with shorter survival (p=0.0066).
- Maximum uptake rate remained a significant predictor of survival after adjusting for clinical covariates.
- Patients with glioblastoma multiforme or anaplastic gliomas showed higher maximum uptake rates compared to those with necrosis (p=0.022).
Conclusions:
- The maximum rate of contrast uptake in dynamic MRI is a significant prognostic factor for malignant gliomas.
- This dynamic MRI parameter may aid in evaluating brain tumor prognosis.
- Further prospective studies are warranted to confirm the clinical utility of this imaging technique.