gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Regional blood volume and blood flow as predictive parameters in low grade astrocytomas

Meeting Abstract

  • P. Warnke - Beth Israel Deaconess Medical Center, Boston, MA, USA
  • E. Kasper - Beth Israel Deaconess Medical Center, Boston, MA, USA
  • K. Kopitzki - Beth Israel Deaconess Medical Center, Boston, MA, USA
  • C. Ostertag - Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.05-03

DOI: 10.3205/09dgnc020, URN: urn:nbn:de:0183-09dgnc0200

Published: May 20, 2009

© 2009 Warnke et al.
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Outline

Text

Objective: To establish predictive parameters in low-grade gliomas treated with interstitial radiosurgery we studied astrocytomas WHO II as to their regional blood volume and blood flow and correlated these findings with progression-free and overall survival.

Methods: 38 astrocytomas WHO II were enrolled and rCBF was measured using stable Xenon CT as well as perfusion CT with bolus tracking. rCBV was measured using a two-compartment model and voxel-based analysis for plasma vascular space and extracellular space. Patients were treated with I-125 interstitial radiosurgery and followed for a median of 6.8 years. Correlation between physiological parameters and PFS, OS and a modified McDonald response were performed using multivariate analysis.

Results: rCBV ranged between 0.008 and 0.07 ml/g and was not related to tumor size or location.rCBF ranged from 19.4 to 56.3 ml/100g/min and also was not correlated to size and location. Treatment response and OS were related to rCBV (p<0.05) and inversely related to rCBF (p<0.01). In contrast to previously published work on oligodendrogliomas and response to chemotherapy higher rCBV was associated with a more prolonged response to interstitial radiosurgery.

Conclusions: The rCBV of low grade astrocytomas is an independent prognostic variable for treatment response and substantiates the radiobiological evidence that radiosurgery relies on tumor vessels to be effective.