CORRELATION BETWEEN DYNAMIC MRI AND OUTCOME IN PATIENTS WITH MALIGNANT GLIOMAS

We assessed the correlation between dynamic MRI results and clinical o utcomes in patients with malignant gliomas. Rapid serial MRIs were obt ained after bolus injection of gadolinium that resulted in an initial fast uptake followed by a slow uptake of contrast. The maximum rate of uptake and delayed rate of uptake were correlated with survival and p rognostic covariates such as age and histology. In 121 subjects, highe r maximum uptake rates, 3.6 signal intensity units per second or great er, were associated with shorter survival (p = 0.0066). The correlatio n of delayed rate of uptake with survival was less significant. After adjusting for age, histology, and Karnofsky performance score, the max imum rate of uptake remained more significantly correlated with surviv al than the delayed rate of uptake. Thirty-one patients had surgery wi thin 1 month of dynamic MRI, and those with glioblastoma multiforme or anaplastic gliomas had higher maximum rates of uptake than those with pure necrosis or mixed tumor and necrosis (p = 0.022). No correlation between delayed rate of uptake and histology was seen in this group o f patients. Our results suggest that the maximum rate of uptake in dyn amic MRI can be a prognostic measure for patients with malignant gliom as. Further prospective study is needed to assess the utility of this technique for evaluating brain tumors.