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Prognostic value of perfusion MR imaging in patients with oligodendroglioma: A survival study - 17/03/11

Doi : 10.1016/j.neurad.2010.03.004 
Z. Jiang a, f, g, i, J.-F. Le Bas a, , f , S. Grand a, f, C. Salon d, C. Pasteris e, D. Hoffmann b, F. Bing a, F. Berger c, f, S. Chabardes b, C. Liu h, i, A. Krainik a, f
a Department of Neuroradiology and MRI, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France 
b Department of Neurosurgery, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France 
c Department of Neurooncology, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France 
d Department of Neuropathology, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France 
e Department of Radiotherapy, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France 
f Inserm U836/UJF/CEA, institut des neurosciences de Grenoble, La Tronche, BP 170, 38042 Grenoble cedex 9, France 
g Department of Radiology, the 2nd affiliated Hospital of Soochow University (hôpital sino-français de Suzhou), 1055, rue San Xiang, Suzhou, 215004 Jiangsu, China 
h Department of Neurology, the 2nd affiliated Hospital of Soochow University (hôpital sino-français de Suzhou), 1055, rue San Xiang, Suzhou, 215004 Jiangsu, China 
i Institute of Neuroscience, Soochow University, Suzhou, 215000 Jiangsu, China 

Corresponding author.

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Summary

Objective

The purpose of this study was to evaluate retrospectively whether cerebral blood volume measurement based on pretreatment perfusion MRI is a prognostic biomarker for survival in patients with oligodendroglioma or mixed oligoastrocytoma.

Patients and methods

Between 1998 and 2004, 54 patients (23 females and 31 males), aged 21–73 years, with oligodendroglioma (or mixed tumour) were examined prior to beginning treatment with dynamic susceptibility-weighted contrast (DSC) perfusion MRI during gadolinium first-pass. The relative cerebral blood volume (rCBV) was calculated by dividing the measurement within the tumour by the measurement of the normal-appearing contralateral region. Patients were classified in two groups, grade A and grade B, according to the Saint-Anne Hospital classification and followed-up clinically and by means of MRI until their death or for a minimum of 5 years. Patients were also classified in grade II and grade III–IV, according to the World Health Organisation (WHO) classification, and were analysed with the same methods. Age, sex, treatment, tumour grade, contrast agent uptake, and rCBV were tested using survival curves with Kaplan-Meier’s method, and their differences were analysed using the log-rank test.

Results

In this population, median survival was 3 years. A rCBV threshold value of 2.2 was validated as a prognostic factor, for survival in these patients with oligodendrogliomas. Age, sex, contrast uptake, and maximum rCBV were found to be prognostic factors in univariate analysis. Multivariate analysis revealed that tumour grade (grade A/grade B), rCBV, age, and sex were prognostic factors independent of the other factors. The tumour grade according to the WHO classification (II versus III–IV) was also detected as an independent prognostic factor.

Conclusion

Pretreatment rCBV measured by DSC perfusion MRI was found to be a prognostic factor for survival in patients with oligodendroglioma or mixed tumour, by using the Saint-Anne Hospital classification, which separate the IIB from the IIA.

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Keywords : Perfusion MRI, Cerebral tumour, Oligodendroglioma, Survival prognosis


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