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The parametric response map is an imaging biomarker for early cancer treatment outcome

Abstract

Here we describe the parametric response map (PRM), a voxel-wise approach for image analysis and quantification of hemodynamic alterations during treatment for 44 patients with high-grade glioma. Relative cerebral blood volume (rCBV) and flow (rCBF) maps were acquired before treatment and after 1 and 3 weeks of therapy. We compared the standard approach using region-of-interest analysis for change in rCBV or rCBF to the change in perfusion parameters on the basis of PRM (PRMrCBV and PRMrCBF) for their accuracy in predicting overall survival. Neither the percentage change of rCBV or rCBF predicted survival, whereas the regional response evaluations made on the basis of PRM were highly predictive of survival. Even when accounting for baseline rCBV, which is prognostic, PRMrCBV proved more predictive of overall survival.

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Figure 1: Schematic diagram of PRM method.
Figure 2: PRMrCBV of nonresponsive and responsive subjects.
Figure 3: Predictive value of imaging biomarkers.

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Acknowledgements

This work was supported by the US National Institutes of Health research grants P01CA085878, U24CA083099 and P50CA093990.

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Authors and Affiliations

Authors

Contributions

C.J.G. conducted data and statistical analyses and wrote the manuscript, T.L.C. acquired and post-processed the MRI data, C.R.M. registered the image data, D.A.H. acquired patient information, C.T., T.S.L. and L.J. accrued subjects and wrote the institutional review board protocol, P.C.S. performed image analysis, T.D.J. aided in the statistics, D.J.R. performed PRM and whole-tumor analysis, A.R. contributed to the design of the study and B.D.R. supervised the project including data analysis and manuscript preparation.

Corresponding author

Correspondence to Brian D Ross.

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Competing interests

C.J.G., T.L.C., C.R.M., A.R. and B.D.R. are entitled to royalties from the licensure of intellectual property studied in this research. This technology has been licensed to ImBio, LLC, a company in which A.R. and B.D.R. have a financial interest.

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Supplementary Tables 1 and 2, Supplementary Figs. 1–6 and Supplementary Discussion (PDF 3839 kb)

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Galbán, C., Chenevert, T., Meyer, C. et al. The parametric response map is an imaging biomarker for early cancer treatment outcome. Nat Med 15, 572–576 (2009). https://doi.org/10.1038/nm.1919

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