{"id":5745,"date":"2023-09-04T03:35:16","date_gmt":"2023-09-04T03:35:16","guid":{"rendered":"https:\/\/cm.vastapps.dev\/tcia-analysis-result\/gbm-mr-ner-outcomes\/"},"modified":"2023-09-13T12:08:12","modified_gmt":"2023-09-13T12:08:12","slug":"gbm-mr-ner-outcomes","status":"publish","type":"tcia_analysis_result","link":"https:\/\/cm.vastapps.dev\/tcia-analysis-result\/gbm-mr-ner-outcomes\/","title":{"rendered":"GBM-MR-NER-OUTCOMES"},"featured_media":0,"template":"","cancer_types":["Glioblastoma"],"citations":[4742,4743,2925],"full_export":"

Description<\/h2>

This manuscript correlates patient survival with morphologic imaging features and hemodynamic parameters obtained from the nonenhancing region (NER) of glioblastoma (GBM), along with clinical and genomic markers. Forty-five patients with GBM underwent baseline imaging with contrast material-enhanced magnetic resonance (MR) imaging and dynamic susceptibility contrast-enhanced T2*-weighted perfusion MR imaging.\u00a0 See DSC T2* MR Perfusion Analysis<\/a> for <\/span>more information about the authors' perfusion analysis.\u00a0 <\/span>Molecular and clinical predictors of survival were obtained. Single and multivariable models of overall survival (OS) and progression-free survival (PFS) were explored with Kaplan-Meier estimates, Cox regression, and random survival forests. <\/span><\/p>

Worsening OS (log-rank test, P = .0103) and PFS (log-rank test, P = .0223) were associated with increasing relative cerebral blood volume of NER (rCBV<\/span> NER<\/span> ), which was higher with deep white matter involvement (t test, P = .0482) and poor NER margin definition (t test, P = .0147). NER crossing the midline was the only morphologic feature of NER associated with poor survival (log-rank test, P = .0125). Preoperative Karnofsky performance score (KPS) and resection extent (n = 30) were clinically significant OS predictors (log-rank test, P = .0176 and P = .0038, respectively). No genomic alterations were associated with survival, except patients with high rCBV<\/span> NER<\/span> \u00a0and wild-type epidermal growth factor receptor (EGFR) mutation had significantly poor survival (log-rank test, P = .0306; area under the receiver operating characteristic curve = 0.62). Combining resection extent with rCBV<\/span> NER<\/span> \u00a0marginally improved prognostic ability (permutation, P = .084). Random forest models of presurgical predictors indicated rCBV<\/span> NER<\/span> \u00a0as the top predictor; also important were KPS, age at diagnosis, and NER crossing the midline. A multivariable model containing rCBV<\/span> NER<\/span> , age at diagnosis, and KPS can be used to group patients with more than 1 year of difference in observed median survival (0.49-1.79 years). Conclusion Patients with high rCBV<\/span> NER<\/span> \u00a0and NER crossing the midline and those with high rCBV<\/span> NER<\/span> \u00a0and wild-type EGFR mutation showed poor survival. In multivariable survival models, however, rCBV<\/span> NER<\/span> \u00a0provided unique prognostic information that went above and beyond the assessment of all NER imaging features, as well as clinical and genomic features. <\/span><\/p>