The Role of Dynamic Contrast Enhanced MRI perfusion imaging in post treatment surveillance of patients with high grade gliomas

Neuroimaging is a valuable diagnostic and surveillance tool for high-grade gliomas. DCE-MRI is a
perfusion imaging technique, which can quantitatively evaluate tumour biology, concentrating mostly
on the microcirculation and the enhancement patterns in the surrounding tissue. This retrospective
observational study consisted of 48 post-treatment patients having been diagnosed with high-grade
glioma of the brain. Measurements were taken using DCE-MRI at baseline and at 3-month, 6-month,
9-month and 12-month follow-ups. All data was collected from the UCLH electronic health records.
Perfusion maps, BF, AUC, Ktrans, Kep, Ve and Vp, were generated and processed using commercially
available software. Eight survival analysis models differentiated progression from stable disease and
pseudo-progression from true progression, across the 6- and 12-month timepoints. Models 1 through
4 assessed disease progression based on the initial baseline scan, while models 5 through 8 assessed
progression based on the baseline and the 3-month DCE-MRI scan. All survival analysis models were
statistically significant with high sensitivity and specificity. The starting hypotheses were verified.