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Dynamic Contrast-Enhanced Magnetic Resonance Imaging–Derived kep as a Potential Biomarker of Matrix Metalloproteinase 9 Expression in Patients With Glioblastoma Multiforme: A Pilot Study

Awasthi, Rishi MSc*; Pandey, Chandra M. PhD; Sahoo, Prativa MSc; Behari, Sanjay MCh§; Kumar, Vijendra MS§; Kumar, Shaleen MD; Misra, Shagun MD; Husain, Nuzhat MD; Soni, Priyanka MSc; Rathore, Ram K.S. PhD; Gupta, Rakesh Kumar MD*

Journal of Computer Assisted Tomography: January/February 2012 - Volume 36 - Issue 1 - p 125–130
doi: 10.1097/RCT.0b013e31823f6c59

Objective To look for the association of tissue matrix metalloproteinase 9 (MMP-9) expression with dynamic contrast-enhanced magnetic resonance imaging and to see whether these can prognosticate patients with glioblastoma multiforme (GBM).

Methods Forty-seven patients with GBM underwent dynamic contrast-enhanced magnetic resonance imaging to look for association of its indices with tissue MMP-9 expression using Pearson correlation. Kaplan-Meier survival analysis was performed to study the survival pattern for low-, medium-, and high-tissue MMP-9 expression and k ep values.

Results Among perfusion indices, k ep, k trans, and v e significantly correlated with MMP-9 expression. Matrix metalloproteinase 9 expression was found to be best estimated by k ep using a quadratic model. The 1-year survival in low-, medium-, and high-tissue MMP-9 and k ep groups were 59%, 45%, and 7%, and 59%, 33%, and 15%, respectively.

Conclusion The association of k ep and MMP-9 expression with survival suggests that k ep may be used as imaging biomarker of GBM progression and its prognostication.

From the *Departments of Radiodiagnosis, and †Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; ‡Department of Mathematics and Statistics, Indian Institute of Technology, Kanpur; §Departments of Neurosurgery, and ∥Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and ¶Department of Pathology, Chhatrapati Sahuji Maharj Medical University, Lucknow, India.

Received for publication August 28, 2011; accepted October 25, 2011.

Reprints: Rakesh K. Gupta, MD, MR Section, Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India 226014 (e-mail:;

Rishi Awasthi received financial assistance from Indian Council of Medical Research, New Delhi, India (No.3/1/3/JRF-2007/MPD).

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.