Preoperative relative cerebral blood volume analysis in gliomas predicts survival and mitigates risk of biopsy sampling error.

Autor: McCullough BJ; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA. Brendan.McCullough@Swedish.org.; Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, 550 17th Avenue, Seattle, WA, 98122, USA. Brendan.McCullough@Swedish.org.; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA. Brendan.McCullough@Swedish.org.; Department of Health Services, University of Washington, 4333 Brooklyn Avenue NE, Box 359455, Seattle, WA, 98195, USA. Brendan.McCullough@Swedish.org., Ader V; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA., Aguedan B; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA., Feng X; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA., Susanto D; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA.; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA., Benkers TL; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Henson JW; Piedmont Brain Tumor Center, 2001 Peachtree Road, Suite 645, Atlanta, GA, 30309, USA., Mayberg M; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Cobbs CS; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Gwinn RP; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Monteith SJ; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Newell DW; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Delashaw J Jr; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA., Fouke SJ; Brain and Spine Center, St. Luke's Hospital, 232 South Woods Mill Road, St. Louis, MO, 63117, USA., Rostad S; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA.; Cellnetix Pathology, 1124 Columbia Street, Suite 200, Seattle, WA, 98104, USA., Keogh BP; Swedish Neuroscience Institute, 550 17th Avenue, Seattle, WA, 98122, USA.; Radia, Inc., 19020 33rd Avenue West, Suite 210, Lynwood, WA, 98036, USA.
Jazyk: angličtina
Zdroj: Journal of neuro-oncology [J Neurooncol] 2018 Jan; Vol. 136 (1), pp. 181-188. Date of Electronic Publication: 2017 Nov 02.
DOI: 10.1007/s11060-017-2642-2
Abstrakt: Appropriate management of adult gliomas requires an accurate histopathological diagnosis. However, the heterogeneity of gliomas can lead to misdiagnosis and undergrading, especially with biopsy. We evaluated the role of preoperative relative cerebral blood volume (rCBV) analysis in conjunction with histopathological analysis as a predictor of overall survival and risk of undergrading. We retrospectively identified 146 patients with newly diagnosed gliomas (WHO grade II-IV) that had undergone preoperative MRI with rCBV analysis. We compared overall survival by histopathologically determined WHO tumor grade and by rCBV using Kaplan-Meier survival curves and the Cox proportional hazards model. We also compared preoperative imaging findings and initial histopathological diagnosis in 13 patients who underwent biopsy followed by subsequent resection. Survival curves by WHO grade and rCBV tier similarly separated patients into low, intermediate, and high-risk groups with shorter survival corresponding to higher grade or rCBV tier. The hazard ratio for WHO grade III versus II was 3.91 (p = 0.018) and for grade IV versus II was 11.26 (p < 0.0001) and the hazard ratio for each increase in 1.0 rCBV units was 1.12 (p < 0.002). Additionally, 3 of 13 (23%) patients initially diagnosed by biopsy were upgraded on subsequent resection. Preoperative rCBV was elevated at least one standard deviation above the mean in the 3 upgraded patients, suggestive of undergrading, but not in the ten concordant diagnoses. In conclusion, rCBV can predict overall survival similarly to pathologically determined WHO grade in patients with gliomas. Discordant rCBV analysis and histopathology may help identify patients at higher risk for undergrading.
Databáze: MEDLINE
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