Identifying the survival subtypes of glioblastoma by quantitative volumetric analysis of MRI

J Neurooncol. 2014 Aug;119(1):207-14. doi: 10.1007/s11060-014-1478-2. Epub 2014 May 15.

Abstract

This study was to project a powerful volumetric-related parameter on magnetic resonance imaging (MRI) for classifying patients with glioblastoma multiforme (GBM) into distinct subgroups objectively. The preoperative MRIs of 147 patients with primary GBM were analyzed. Volumetric-related parameters, including V1 (tumor volume), V2 (peritumoral T2/FLAIR hyperintense volume) and V2/V1 (the volume ratio), were estimated by an ellipsoid model. Log-rank analysis and Cox regression methods were used to compare Kaplan-Meier plots and identified prognostic parameters. Log-rank analysis revealed that V1 and V2 were correlated with survival, but the P value was marginally significant (P = 0.082, P = 0.091, for progression-free survival [PFS]; P = 0.120, P = 0.073, for overall survival [OS], respectively). V2/V1 was a potential prognostic factor for both PFS and OS (P < 0.001 and P < 0.001, respectively). Cox regression analysis documented that higher V2/V1 (ratio ≥ 7.0) was independent unfavorable prognostic factor. The odd ratio (OR) of higher V2/V1 was 2.662 (95 % confidence interval [CI], 1.782-3.975; P < 0.001) for PFS and 3.450 (95 % CI, 2.079-5.725; P < 0.001) for OS, respectively. The volumetric-related parameters of V1, V2 and V2/V1 were helpful for predicting the prognosis of patients with GBM. V2/V1 was a more comprehensive and systematic prognostic factor in GBM patient, especially for those with small tumor but large peritumoral T2 hyperintense or large tumor but small peritumoral T2 hyperintense.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain / pathology*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Glioblastoma / mortality
  • Glioblastoma / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Tumor Burden*
  • Young Adult