PURPOSE To examine the applicability of contrast leakage information from dynamic susceptibility contrast-enhanced (DSC) MRI and dynamic contrast-enhanced (DCE) MRI to determine which one is the most valuable surrogate imaging biomarker for predicting disease progression in anaplastic astrocytoma (AA) patients. MATERIALS AND METHODS This study was approved by the institutional review board (IRB), which waived informed consent. A total of seventy-three AA patients who had undergone preoperative DCE and DSC MRI and received standard treatment, including partial resection or biopsy followed by radiation therapy, were included in this retrospective study. Based on Response Assessment in Neuro-Oncology (RANO), patients were sorted into progression (n = 21) and non-progression (n = 52) groups. Tumor boundaries were defined as high-signal intensity (SI) lesions on fluid-attenuated inversion recovery (FLAIR) imaging, where we analyzed mean pharmacokinetic parameters (Ktrans, Vp, and Ve) from DCE MRI and contrast leakage information (mean extraction fraction (EF)) from DSC MRI. RESULTS Mean Ve and mean EF were significantly higher in patients with progression-free survival (PFS) < 18 months than in those with PFS ≥ 18 months. For distinguishing the group with PFS < 18 months, AUC values were calculated using the mean Ve value (AUC = 0.716). The Kaplan-Meier survival analysis revealed that mean Ve value was significantly correlated with PFS. In Cox proportional-hazards regression, only the mean Ve value was found to be significantly associated with PFS. CONCLUSION We found that the mean Ve value based on high-SI tumor lesions on FLAIR imaging was capable of predicting outcomes of AA patients as a potential surrogate imaging biomarker. KEY POINTS • Mean Ve(2.152 ± 1.857 vs. 1.173 ± 1.408) was significantly higher in anaplastic astrocytoma patients with PFS < 18 months that in those with PFS ≥ 18 months (p = 0.02). • Cox proportional-hazards regression showed that only mean Ve(p = 0.034) was significantly associated with PFS, regardless of IDH mutation status, in anaplastic astrocytoma patients.

中文翻译：

---

间变性星形细胞瘤患者预后的预测：动态磁敏感增强MRI和动态增强MRI造影剂泄漏信息的应用。

目的 检查来自动态磁敏感对比增强 (DSC) MRI 和动态对比增强 (DCE) MRI 的造影剂泄漏信息的适用性，以确定哪一个是预测间变性星形细胞瘤 (AA) 患者疾病进展的最有价值的替代成像生物标志物. 材料和方法 这项研究得到了机构审查委员会 (IRB) 的批准，该委员会放弃了知情同意。共有 73 名 AA 患者接受了术前 DCE 和 DSC MRI 并接受了标准治疗，包括部分切除或活检，然后进行放射治疗，被纳入该回顾性研究。基于神经肿瘤学 (RANO) 的反应评估，患者被分为进展组 (n = 21) 和非进展组 (n = 52)。肿瘤边界被定义为液体衰减反转恢复 (FLAIR) 成像上的高信号强度 (SI) 病变，我们在其中分析了 DCE MRI 的平均药代动力学参数（Ktrans、Vp 和 Ve）和造影剂泄漏信息（平均提取分数 ( EF)) 来自 DSC MRI。结果 无进展生存期 (PFS) < 18 个月的患者的平均 Ve 和平均 EF 显着高于 PFS ≥ 18 个月的患者。为了区分 PFS < 18 个月的组，使用平均 Ve 值计算 AUC 值 (AUC = 0.716)。Kaplan-Meier 生存分析显示平均 Ve 值与 PFS 显着相关。在 Cox 比例风险回归中，发现只有平均 Ve 值与 PFS 显着相关。结论 我们发现，基于 FLAIR 成像的高 SI 肿瘤病变的平均 Ve 值能够作为潜在的替代成像生物标志物预测 AA 患者的结果。要点 • 平均 Ve（2.152 ± 1.857 与 1.173 ± 1.408）在 PFS < 18 个月的间变性星形细胞瘤患者中显着高于 PFS ≥ 18 个月的患者 (p = 0.02)。• Cox 比例风险回归表明，在间变性星形细胞瘤患者中，无论 IDH 突变状态如何，只有平均 Ve (p = 0.034) 与 PFS 显着相关。