Table 5.
Serial comparison of cerebral and tumoral blood flow metrics at different time points in patients with glioblastoma
| Pre-op | Post-treatment | Recurrence | Pre-op vs Post-treatment |
Pre-op vs Recurrence | ANOVA (all stages) |
Bonferroni | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| M ± SD | R | N | M ± SD | R | N | M ± SD | R | N | |||||
| Max CBF overall | 49.6 ± 20.0 | 35.2–77.0 | 2, 81 | 35.0 ± 0.0 | 1, 18 |
t = 11.0, p < 0.001 |
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| Mean CBF white matter ipsilateral | 24.9 ± 1.2 | 23.7–26.1 | 2, 49 | 26.1 ± 0.0 | 1, 32 |
t = 6.79, p < 0.001 |
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| Mean CBF white matter contralateral | 25.6 ± 0.2 | 25.4–25.7 | 2, 49 | 26.0 ± 0.0 | 1, 32 |
t = 20.0, p < 0.001 |
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| Mean perilesional flow | 15.5 ± 3.3 | 13.5–20.6 | 2, 35 | 18.8 ± 0.0 | 1, 32 |
t = 5.9, p < 0.001 |
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| Mean TBF | 98.0 ± 34.5 | 49.0–136.5 | 7, 154 | 68.2 ± 0.0 | 1, 32 |
t = 10.7, p < 0.001 |
|||||||
| Max TBF | 145.5 ± 48.0 | 74.5–250.0 | 6, 214 | 75.0 ± 15.1 | 45.0–82.5 | 2, 90 |
t = 16.5, p < 0.001 |
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| Max rTBF - all reference ROIs | 5.1 ± 2.5 | 1.6–9.5 | 13, 342 | 5.4 ± 0.0 | 1, 26 | 2.5 ± 0.0 | 1, 72 |
t = 2.6, p = 0.009 |
F = 15.4, p < 0.001 |
Pre-op vs Post-op, p = 0.016 Pre-op vs first recurrence, p < 0.001 Post-op vs first recurrence, p < 0.001 |
|||
| Max rTBF - white matter reference | 4.8 ± 1.9 | 1.6–7.3 | 6, 118 | 5.4 ± 0.0 | 1, 26 | 2.5 ± 0.0 | 1, 72 |
t = 3.23, p = 0.002 |
F = 23.0, p < 0.001 |
Pre-op vs Post-op, p < 0.001 Pre-op vs first recurrence, p < 0.001 Post-op vs first recurrence, p < 0.001 |
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ANOVA, One way analysis of variance; CBF, Cerebral blood flow; M ± SD, Mean±standard deviation; N, Number of studies followed by number of patients between studies; N/A, Current statistical test could not be performed; R, Range; ROI, Region of interest; TBF, Tumoral blood flow; rTBF, Relative tumoral blood flow.
Results were compared at three different time points: preoperatively, post-treatment (after surgery ±adjuvant treatment) and at recurrence. Comparisons were made using independent t-tests or one-way analysis of variance with post-hoc Bonferroni tests, as required. There was a marginal but significant increase in CBF following treatment. Changes in TBF were more variable, with a reduction in absolute mean TBF, but increase in rTBF. All absolute flow metrics are in ml/100 g/min and all relative flow values are unitless.