Volumetric assessment of glioblastoma and its predictive value for survival

• Verfasst von: Henker, Christian [VerfasserIn]
• Verfasst von: Hiepel, Marie Cristin [VerfasserIn]
• Verfasst von: Kriesen, Thomas [VerfasserIn]
• Verfasst von: Scherer, Moritz [VerfasserIn]
• Verfasst von: Glass, Änne [VerfasserIn]
• Verfasst von: Herold-Mende, Christel [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Langner, Sönke [VerfasserIn]
• Verfasst von: Weber, Marc-André [VerfasserIn]
• Verfasst von: Schneider, Björn [VerfasserIn]
• Verfasst von: Unterberg, Andreas [VerfasserIn]
• Verfasst von: Piek, Jürgen [VerfasserIn]
• Titel: Volumetric assessment of glioblastoma and its predictive value for survival
• Verf.angabe: Christian Henker, Marie Cristin Hiepel, Thomas Kriesen, Moritz Scherer, Änne Glass, Christel Herold-Mende, Martin Bendszus, Sönke Langner, Marc-André Weber, Björn Schneider, Andreas Unterberg, Jürgen Piek
• E-Jahr: 2019
• Jahr: 28 June 2019
• Umfang: 10 S.
• Fussnoten: Gesehen am 13.11.2019
• Titel Quelle: Enthalten in: Acta neurochirurgica
• Ort Quelle: Wien [u.a.] : Springer, 1950
• Jahr Quelle: 2019
• Band/Heft Quelle: 161(2019), 8, Seite 1723-1732
• ISSN Quelle: 0942-0940
• DOI: doi:10.1007/s00701-019-03966-6
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Glioblastoma
• Sach-SW: Magnetic resonance imaging
• Sach-SW: Necrosis
• Sach-SW: Neuroimaging
• Sach-SW: Prognosis
• Sach-SW: Survival
• K10plus-PPN: 1681810735

Abstract

BackgroundThe objective of this study was to evaluate the morphology of glioblastoma on structural pretreatment magnetic resonance imaging (MRI), defining imaging prognostic factors.MethodWe conducted a retrospective analysis of MR images from 114 patients harboring a primary glioblastoma, derived from two neurosurgical departments. Tumor segmentation was carried out in a semi-automated fashion. Tumor compartments comprised contrast-enhancing volume (CEV+), perifocal hyperintensity on fluid-attenuated inversion recovery (FLAIR) images (FLAIR+) excluding CEV+, and a non-enhancing area within the CEV+ lesion (CEV−). Additionally, two ratios were calculated from these volumes, the edema-tumor ratio (ETR) and necrosis-tumor ratio (NTR). All patients received surgical resection, followed by concomitant radiation and chemotherapy.ResultsTumor segmentation revealed the strongest correlation between the CEV+ volume and the CEV−, presenting intratumoral necrosis (p < 0.001). The relation between the tumor surrounding the FLAIR+ area and the CEV+ volume and the ETR is inversely correlated (p = 0.001). The most important prognostic factor in multivariable analysis was NTR (HR 2.63, p = 0.016). The cut-off value in our cohort for NTR was 0.33, equivalent to a decrease in survival if the necrotic core of the tumor (CEV−) accounts for more than 33% of the tumor mass itself (CEV+).ConclusionsOur data emphasizes the importance of the necrosis-tumor ratio as a biomarker in glioblastoma imaging, rather than single tumor compartment volumes. NTR can help to identify a subset of tumors with a higher resistance to therapy and a dismal prognosis.