Ventricle contact is associated with lower survival and increased peritumoral perfusion in glioblastoma.
van Dijken, Bart Roelf Jan
Jan van Laar, Peter
Boonzaier, Natalie Rosella
van der Hoorn, Anouk
Journal of neurosurgery
American Association of Neurological Surgeons
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van Dijken, B. R. J., Jan van Laar, P., Li, C., Yan, J., Boonzaier, N. R., Price, S., FCRS,, & et al. (2018). Ventricle contact is associated with lower survival and increased peritumoral perfusion in glioblastoma.. Journal of neurosurgery, 131 (3), 717-723. https://doi.org/10.3171/2018.5.jns18340
Object: To prospectively investigate outcome and differences in peritumoral MRI characteristics of ventricle contacting and non-contacting glioblastomas. Glioblastomas are heterogeneous tumors with variable survival. Lower survival is suggested for patients with ventricle contacting tumors compared to non-contacting tumors. This might be supported by aggressive peritumoral MRI features. However, differences in MRI characteristics of the peritumoral environment between ventricle contacting and non-contacting glioblastomas have not yet been investigated. Methods: Newly diagnosed glioblastoma patients underwent preoperative MRI with contrast enhanced T1, FLAIR, diffusion, and perfusion imaging. Tumors were categorized into ventricle contacting or non-contacting based on the contrast enhancement. Survival analysis was performed using log-rank for univariate and cox-regression for multivariate analysis. Normalized perfusion (rCBV) and diffusion (ADC) values were calculated in two regions; the peritumoral non-enhancing FLAIR overlapping the subventricular zone and the remaining peritumoral non-enhancing FLAIR region. Results: Overall survival was significantly lower in contacting tumors than non-contacting tumors (434 versus 747 days; p<0.001). Progression-free survival showed a comparable trend (260 versus 375 days; p=0.094). Multivariate analysis confirmed a survival difference for both overall (HR 3.930 (95%CI 1.740–8.875), p=0.001) and progression-free survival (HR 2.506 (95%CI 1.254–5.007), p=0.009). Peritumoral perfusion was higher in contacting than in non-contacting tumors for both FLAIR regions (p=0.04). There was no difference in peritumoral ADC values between the two groups. Conclusion: Patients with ventricle contacting tumors demonstrated a poorer outcome compared to patients with non-contacting tumors. This disadvantage of ventricle contact might be explained by higher peritumoral perfusion leading to more aggressive behavior.
FCRS, Cerebral Ventricles, Humans, Glioblastoma, Brain Neoplasms, Magnetic Resonance Imaging, Treatment Outcome, Survival Rate, Cohort Studies, Cerebrovascular Circulation, Adult, Aged, Middle Aged, Female, Male, Young Adult, Multimodal Imaging
NIHR Clinician Scientist Fellowship
Embargo Lift Date
External DOI: https://doi.org/10.3171/2018.5.jns18340
This record's URL: https://www.repository.cam.ac.uk/handle/1810/279371