The prognostic value of perfusion MRI in cerebral glioma

摘要: Introduction Cerebral glioma is the most prevalent primary brain tumour, of which majority are high grade gliomas. High gliomas possess a poor prognosis, and glioblastoma patients survive less than one year after diagnosis. To date, histological grading used as standard technique for diagnosis survival prediction. Previous studies using advanced techniques such MR Perfusion have achieved sensitivity but low specificity in identifying Moreover, they failed to distinguish from anaplastic glioma. The purpose study presented here assess diagnostic prognostic value cerebral blood volume maps derived perfusion. Methods This retrospective was approved by local research ethics committee clinical audit office. This included 123 with newly diagnosed glioma, all grades. Histological reference potential patients. relative tumour (rTBVmax) perfusion radiological Receiver operating characteristics (ROC) were define best threshold distinguishing grades determining accuracy values (sensitivity, specificity, positive negative predictive values). For analysis, Kaplan-Meier illustrate compare discriminatory classifications. A multiple Cox regression model both classifications addition other tested demographic variables. Finally, influence moderators assessed ANOVA, whether variation rTBVmax only due difference grades. Results A data set (n = 50) produced 7-fold increase TBVmax versus white matter provided 97% 94%, respectively, 9.6 100% 56% differentiating within group These applied second 73) 96% 95% 73% differentiating, gliomas, Using these two thresholds three-tier classification, plots showed that classification independent predictor progression. proposed system better predicting especially noted moderately hyperaemic rTBVmax. Conclusion MR non-invasive robust promising. It may role future defining appropriate treatment. However, inferior multiforme. In future, more multimodal MR, spectroscopy diffusion, be studied, besides perfusion, order improve this accuracy.