The comparative study of multimodal MRI techniques in prognosis of glioblastoma

Abstract

Objective To investigate the prognostic value of dynamic susceptibility contrast⁃enhanced MRI (DSC⁃MRI), 3D⁃arterial spin labeling (3D⁃ASL) and intravoxel incoherentmotion (IVIM) in glioblastoma. Methods From August 2016 to October 2017, a total of 34 patients with glioblastoma were enrolled. According to the overall survival (OS), they were divided into < 14 months group (17 cases) and ≥ 14 months group (17 cases). MRI conventional sequences, DSC⁃MRI, 3D⁃ASL, IVIM were acquired before operation. Multiple regions of interest (ROIs) were placed in the tumor⁃enhanced region and the peritumoral region, and recorded the values of DSC⁃maximum relative cerebral blood volume (DSC⁃rCBV max ) and relative cerebral blood flow (DSC⁃rCBF), ASL⁃cerebral blood flow (ASL⁃CBF), IVIM⁃perfusion fraction (PF). Receiver operating characteristic (ROC) curve was used to evaluated the prognostic value of the imaging indicators. Results There were no significant differences in ASL⁃CBF, IVIM⁃PF, DSC⁃rCBF and DSC⁃rCBV max between the OS < 14 months group and the OS ≥ 14 months group in tumor⁃enhanced region (P > 0.05, for all). In the peritumoral region, the IVIM⁃PF of the patients in OS < 14 months was lower (P = 0.011) while DSC⁃rCBF (P = 0.009) and DSC⁃rCBV max (P = 0.012) were higher than OS ≥ 14 months group. The area under the ROC curve was 0.579 (95%CI: 0.372-0.787, P = 0.453), 0.763 (95%CI: 0.588-0.937, P = 0.013) and 0.746 (95%CI: 0.565-0.926, P = 0.020) respectively, suggesting that DSC⁃rCBF and DSC⁃ rCBV max have better reference value for prognosis. Conclusions The imaging indicators of DSC⁃MRI have an effect on the OS of glioblastoma, while IVIM and ASL have not shown an effect on overall survival.

DOI：10.3969/j.issn.1672⁃6731.2019.11.008