Preoperative Prognostic Value of Dynamic Contrast-Enhanced MRI–Derived Contrast Transfer Coefficient and Plasma Volume in Patients with Cerebral Gliomas

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Fig 1.
Kaplan-Meier analysis of overall survival according to histopathologic grades. A, All patients (between grades 2 and 3, P = .8; and between grades 3 and 4, P = .02). B, All patients, excluding those with low-grade gliomas who had a biopsy (between grades 2 and 3, P = .2; between grades 3 and 4, P = .02).
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Fig 2.
Kaplan-Meier analysis of overall survival according to K^trans. A, All patients (P = .0001). B, Those with low-grade gliomas (P = .002). C, Those with high-grade gliomas (P = .004).
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Fig 3.
Kaplan-Meier analysis of overall survival according to V_p. A, All patients (P = .0004). B, Those with low-grade gliomas (P = .005). C, Those with high-grade gliomas (P = .02).

Table 1:

Summary of clinical characteristics as univariate predictors of overall survival in 46 patients with gliomas

Characteristics	No.	%	HR (95% CI)	P Value
Age
50 Years or younger	18	39.1	1
Older than 50 years	28	60.9	7.62 (2.17–26.71)	.002
Karnofsky performance score
≥80	25	54.3	1
<80	21	45.7	2.86 (1.35–6.08)	.007
Maximal tumor diameter
<4 cm	17	37	1
≥4 cm	29	63	1.30 (0.61–2.80)	.50
Surgery
Biopsy only	9	19.6	1
Resection	37	80.4	4.19 (1.77–9.93)	.001
Histopathologic grade
Grade 2 (8 pure astrocytomas, 1 oligodendroglioma)	9	19.6	1
Grade 3 (6 pure astrocytomas, 2 oligoastrocytomas, 1 oligodendroglioma)	9	19.6	0.087 (0.83–9.45)	.87
Grade 4 (26 pure astrocytomas, 2 oligoastrocytomas)	28	40.8	4.14 (1.25–13.8)	.02
Steroid administration
No	18	39.1	1
Yes	28	61.9	2.11 (0.96–4.65)	.06

Table 2:

Summary of imaging characteristics as univariate predictors of overall survival in 46 patients with gliomas

Characteristics	No.	%	HR (95% CI)	P Value
Sequence
2D	31	67	1
3D	15	33	1.00 (0.44 to 2.29)	.99
Contrast enhancement
None/less than that of choroid plexus	15	33	1
Equal/more than that of choroid plexus	31	67	8.11 (2.44–26.90)	.0007
K^trans (min⁻¹)
<0.05	17	37.0	1
≥0.05	29	63.0	7.63 (2.63–22.11)	.0002
V_p (mL/100 g)
<5	20	43.5	1	.003
≥5	26	56.5	4.17 (1.77–9.80)	.001

Table 3:

Three models combining an imaging parameter with clinical factors as potential prognostic variables of overall survival in patients with gliomas

Factors	HR (95% CI)	P Value
Model 1
Age older than 50 yr	1.03 (0.99–1.06)	.17
Biopsy vs resection	4.11 (1.68–10.05)	.002
Grade 3 vs 2	1.20 (0.19–7.65)	.85
Grade 4 vs 2	1.21 (0.28–5.33)	.80
Karnofsky score < 80	2.56 (1.19–5.51)	.02
K^trans ≥ 0.05 min⁻¹	4.53 (1.22–16.82)	.02
Model 2
Age older than 50 yr	1.06 (1.03–1.09)	.0002
Biopsy vs resection	3.68 (1.54–8.78)	.004
Grade 3 vs 2	1.06 (0.16–6.89)	.95
Grade 4 vs 2	1.76 (0.35–8.75)	.49
Karnofsky score < 80	3.21 (1.48–6.92)	.003
V_p ≥ 5 mL/100 g	1.30 (0.37–4.54)	.68
Model 3
Age older than 50 yr	1.03 (0.99–1.07)	.087
Biopsy vs resection	4.36 (1.77–10.77)	.002
Grade 3 vs 2	1.28 (0.20–8.25)	.79
Grade 4 vs 2	1.00 (0.22–4.63)	.99
Karnofsky score < 80	2.51 (1.16–5.43)	.02
Marked contrast enhancement	4.79 (1.22–18.87)	.03