Perfusion MRI can predict progression of gliomas

April 29, 2008

NEW YORK (Reuters Health) - By measuring cerebral blood volume (CBV), dynamic susceptibility-weighted contrast-enhanced perfusion MRI can predict the time to progression of high- and low-grade gliomas, according to a report in the May issue of Radiology.

The findings indicate that patients with a high relative CBV have a shorter time to disease progression than do patients with a low relative CBV, Dr. Meng Law, from Mount Sinai Medical Center in New York, and colleagues report.

"There are significant limitations with our current standard reference for predicting glioma biology and we need and likely have novel biomarkers for predicting biology, such as perfusion," Dr. Law told Reuters Health.

The present study is not the first to look at MRI-based CBV measurement in assessing the prognosis of gliomas. "The novelty and significance of our study," Dr. Law noted, "is the large number of patients studied. Most prior studies have included smaller cohorts (10-30). The 189 patients presented in our study I believe represent the largest number published."

In the study, patients with a complete treatment response and those with stable disease had mean relative CBV values of 1.41 and 2.36, respectively. By contrast, patients with progressive disease and those who died had much higher values, 4.84 and 3.82, respectively.

With a relative CBV of less than 1.75, the researchers calculate that the median time to disease progression was 3585 days. With higher values, the median time was just 265 days.

Relative CBV, as well as patient age, were also independently associated with clinical outcome, the findings indicate.

Dr. Law said that a number of studies are now underway "which aim to, first, standardize perfusion MRI between multiple institutions and, second, collect multi-center data with a view to performing larger prospective multi-center trials."