Leakage correction improves prognosis prediction of dynamic susceptibility contrast perfusion MRI in primary central nervous system lymphoma

Yeon Soo Kim,Koung Mi Kang,Tae Min Kim,Ji-Hoon Kim,Tae Jin Yun,Il Han Kim,Sung-Hye Park,Jae-Kyung Won,Roh-Eul Yoo,Seung Hong Choi,Chul-Ho Sohn,Chul-Kee Park

doi:10.1038/s41598-017-18901-x

Yeon Soo Kim, Koung Mi Kang + Show 10 more

Open Access

https://doi.org/10.1038/s41598-017-18901-x

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Abstract

To evaluate whether the cerebral blood volume (CBV) measurement with leakage correction from dynamic susceptibility contrast perfusion weighted imaging can be useful in predicting prognosis for primary central nervous system lymphoma (PCNSL). 46 PCNSL patients were included and classified by radiation therapy (RT) stratification into RT (n = 30) and non-RT (n = 16) groups. The corresponding histogram parameters of normalized CBV (nCBV) maps with or without leakage correction were calculated on contrast-enhanced T1 weighted image (CE T1WI) or on fluid attenuated inversion recovery image. The 75th percentile nCBV with leakage correction based on CE T1WI (T1 nCBVL75%) had a significant difference between the short and long progression free survival (PFS) subgroups of the RT group and the non-RT group, respectively. Based on the survival analysis, patients in the RT group with high T1 nCBVL75% had earlier progression than the others with a low T1 nCBVL75%. However, patients in the non-RT group with a high T1 nCBVL75% had slower progression than the others with a low T1 nCBVL75%. Based on RT stratification, the CBV with leakage correction has potential as a noninvasive biomarker for the prognosis prediction of PCNSL to identify high risk patients and it has a different correlation with the PFS based on the presence of combined RT.

Highlights

Primary central nervous system lymphoma (PCNSL) is a rare primary brain cancer as an extra-nodal variant of non-Hodgkin lymphoma confined to the central nervous system with variable response to treatment and clinical outcomes[1,2,3]
There have been relatively few studies of the effectiveness of dynamic susceptibility contrast perfusion weighted imaging (DSC PWI) derived normalized cerebral blood volume values in PCNSL that can assess the degree of tumor angiogenesis, and capillary permeability to assess the response to therapy compared to gliomas[10,11]
We hypothesized that the normalized cerebral blood volume (nCBV) values could have potential as noninvasive quantitative prognostic factors for the progression free survival (PFS) and their relationship with the PFS could be different based on the treatment modalities

Summary

Introduction

Primary central nervous system lymphoma (PCNSL) is a rare primary brain cancer as an extra-nodal variant of non-Hodgkin lymphoma confined to the central nervous system with variable response to treatment and clinical outcomes[1,2,3]. The cornerstone of therapy is a systemic treatment with intravenous high-dose methotrexate, there remains controversy about the role of RT3. For this reason, combined RT is not strongly recommended, Medicine, Seoul, Korea. There have been relatively few studies of the effectiveness of dynamic susceptibility contrast perfusion weighted imaging (DSC PWI) derived normalized cerebral blood volume (nCBV) values in PCNSL that can assess the degree of tumor angiogenesis, and capillary permeability to assess the response to therapy compared to gliomas[10,11].

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