Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-02-17 DOI:10.1186/s13244-025-01900-2

Peng Lin, Jin-Shu Pang, Ya-Dan Lin, Qiong Qin, Jia-Yi Lv, Gui-Qian Zhou, Tian-Ming Tan, Wei-Jia Mo, Gang Chen

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引用次数: 0

Abstract

Objectives: To evaluate the ability of sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR).

Methods: Preoperative MRI scans were retrospectively analysed in IDH-wildtype GBM patients from two datasets. After MRI preprocessing and tumour segmentation, tumour sphericity was calculated based on the tumour core region. The prognostic value of tumour surface regularity was evaluated via Kaplan-Meier (K-M) plots, univariate and multivariate Cox proportional hazards analyses. In different surface regularity subgroups, the OS benefit from GTR was evaluated via K-M plots and the restricted mean survival time (RMST).

Results: This study included 367 patients (median age, 62.0 years [IQR, 54.5-70.5 years]) in the discovery cohort and 475 patients (median age, 63.6 years [IQR, 56.2-71.3 years]) in the validation cohort. Sphericity was an independent predictor of OS in the discovery (p = 0.022, hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.06-1.99) and validation groups (p = 0.007, HR = 1.38, 95% CI: 1.09-1.74) according to multivariate analysis. Age, extent of resection, and surface regularity composed a prognostic model that separated patients into subgroups with distinct prognoses. Patients in the surface-irregular subgroup benefited from GTR, but patients in the surface-regular subgroup did not in the discovery (p < 0.001 vs. p = 0.056) and validation datasets (p < 0.001 vs. p = 0.11).

Conclusions: The high surface regularity of IDH-wildtype GBM is significantly correlated with better OS and does not benefit substantially from GTR.

Critical relevance statement: The proposed imaging marker has the potential to increase the survival prediction efficacy for IDH-wildtype glioblastomas (GBMs), offering a valuable indicator for clinical decision-making.

Key points: Sphericity is an independent prognostic factor in IDH-wildtype glioblastomas (GBMs). High sphericity in IDH-wildtype GBM is significantly correlated with better survival. GBM patients with low sphericity could receive survival benefits from gross tumour resection.

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肿瘤表面的规律性预测了idh野生型胶质母细胞瘤患者的生存和总体全切除术的益处。

目的：评估胶质母细胞瘤（GBMs）的球形性预测总生存期（OS）和肿瘤切除术（GTR）的生存获益的能力。方法：回顾性分析来自两个数据集的idh野生型GBM患者的术前MRI扫描。经过MRI预处理和肿瘤分割后，根据肿瘤核心区域计算肿瘤球度。通过Kaplan-Meier （K-M）图、单因素和多因素Cox比例风险分析评估肿瘤表面规律性的预后价值。在不同的表面规则亚组中，通过K-M图和限制平均生存时间（RMST）评估GTR的OS效益。结果：本研究纳入发现队列367例患者（中位年龄62.0岁[IQR， 54.5-70.5岁]），验证队列475例患者（中位年龄63.6岁[IQR， 56.2-71.3岁]）。多因素分析显示，球形度是发现组(p = 0.022，风险比（HR) = 1.45, 95%可信区间（CI） 1.06-1.99）和验证组（p = 0.007, HR = 1.38, 95% CI: 1.09-1.74） OS的独立预测因子。年龄、切除程度和表面的规律性组成了一个预后模型，该模型将患者分为预后不同的亚组。表面不规则亚组的患者受益于GTR，但表面规则亚组的患者在发现中没有(p)结论：idh -野生型GBM的高表面规定性与更好的OS显着相关，并没有从GTR中获得实质性的好处。关键相关性声明：提出的成像标记物有可能提高idh野生型胶质母细胞瘤（GBMs）的生存预测功效，为临床决策提供有价值的指标。重点：球形是idh野生型胶质母细胞瘤（GBMs）的独立预后因素。idh野生型GBM的高球形度与更好的生存率显著相关。球形度低的GBM患者可以从肿瘤切除术中获得生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.