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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Volumetric analysis of preoperative MRI as a tool for GBM prognosis estimation

Volumetrische Analyse des präoperativen MRT für die Evaluation der GBM Prognose

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  • presenting/speaker Arsenij Petrov - Universitätsmedizin Göttingen, Klinik für Neurochirurgie, Göttingen, Deutschland
  • presenting/speaker Alexandra Sachkova - Universitätsmedizin Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Farez Komboz - Universitätsmedizin Göttingen, Klinik für Neurochirurgie, Göttingen, Deutschland
  • Dorothee Mielke - Universitätsmedizin Göttingen, Klinik für Neurochirurgie, Göttingen, Deutschland
  • Hans Christoph Bock - Universitätsmedizin Göttingen, Klinik für Neurochirurgie, Göttingen, Deutschland
  • Veit Rohde - Universitätsmedizin Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Vesna Malinova - Universitätsmedizin Göttingen, Neurochirurgie, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP198

doi: 10.3205/19dgnc534, urn:nbn:de:0183-19dgnc5345

Published: May 8, 2019

© 2019 Petrov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The volumetric analysis of tumor and tumor-associated FLAIR hyperintensity represents a potential tool for risk stratification and therapy monitoring in GBM patients. The dynamics of FLAIR in peritumoral area was shown to predict the tumor recurrence in several trials. Preoperative tumor volume and FLAIR volume significantly correlate with survival in uni- and multivariate analysis. In this study, we analyzed various imaging characteristics of tumor and tumor-associated edema in GBM patients from a single-center tumor registry.

Methods: We reviewed the data of 242 patients (94 female) treated for GBM WHO IV at our institution between 2010 and 2017. Patient and tumor characteristics, operative and adjuvant therapies, as well as progression free survival and overall survival were recorded. Volumetric analysis was performed in Brainlab Software. Statistical analysis was done with the help of Statistica software (Statsoft).

Results: The overall survival of our patient cohort was 15,2 months and progression-free survival 7,5 months. The majority of patients received concomitant radiochemotherapy (Stupp protocol) as a first-line treatment. The mean tumor volume was 43,91 cm3 and the mean FLAIR volume 102,43 cm3. There was no significant correlation of the tumor and FLAIR volume with sex, age, molecular markers (IDH1 mutation, MGMT promoter methylation). The linear regression analysis showed no significant correlation between overall and progression-free survival and the volume of tumor and FLAIR hyperintensity at the initial imaging. The tumor ventricular contact was a significant predictive factor for poor survival (10,03 months vs. 26,64 months, p<0,001), which could be reproduced in tumors which undergone a gross total resection (9,5 months vs. 21,9 months, p=0,055).

Conclusion: The overall as well as the progression free survival does not correlate with the volume of tumor and tumor-associated FLAIR hyperintensity. The ventricular contact of the tumor is a significant negative predictive factor for patient survival.