Automated Volumetric Analysis of Postoperative Magnetic Resonance Imaging Predicts Survival in Patients with Glioblastoma

World Neurosurg. 2019 Jun:126:e1510-e1517. doi: 10.1016/j.wneu.2019.03.142. Epub 2019 Mar 22.

Abstract

Background: Glioblastomas (GBMs) are primary brain tumors that are very difficult to treat. Magnetic resonance imaging (MRI) is the reference tool for diagnosis, postoperative control, and follow-up of GBM. The MRI tumor contrast enhancement part serves as a target for surgery. However, there are controversial data about the influence of pre- and postoperative tumor volumetric MRI parameters on overall survival (OS).

Methods: Data of 57 patients with GBM were analyzed retrospectively. All patients had maximum safe resection and standard adjuvant treatment. All patients underwent 1.5-T MRI with contrast in the first 24 hours postoperatively. The data of pre- and postoperative volumetric parameters were analyzed using the original software.

Results: Correlation analysis between the postoperative volume of the tumor contrast enhancement part and the patient's OS revealed a significant level (on the Chaddock scale) of inverse correlation. Residual tumor volume associated with OS of >6 months was determined as <2.5 cm3. The mortality risk in the first 6 months after tumor resection is 3.4 times higher when the tumor remnant is >2.5 cm3 (risk ratio, 3.4; P = 0.0002).

Conclusions: The volume of MRI contrast-enhancing GBM remnants after surgery, automatically measured by the software, was a significant predictor for early postoperative progression and death.

Keywords: Glioblastoma management; Gross total resection; MRI evaluation; Software for MRI; Volumetric tumor estimation.

MeSH terms

  • Adult
  • Aged
  • Automation
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / surgery
  • Contrast Media
  • Female
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / mortality
  • Glioblastoma / surgery
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm, Residual / surgery
  • Neurosurgical Procedures / methods
  • Predictive Value of Tests
  • Retrospective Studies
  • Software
  • Survival Analysis
  • Young Adult

Substances

  • Contrast Media