Glioblastoma IDH-wild type: imaging independent predictors of gross total resection (GTR) using the VASARI feature set and tumoral volumetric measurements.
IF 1.1 4区 医学Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
David Timaran-Montenegro, Luis Nunez, Antonio Dono, Octavio Arevalo, Andres Rodriguez, Kamand Khalaj, Jennifer McCarty, Jay-Jiguang Zhu, Yoshua Esquenazi, Roy Riascos
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引用次数: 0
Abstract
BackgroundExtent of resection (EOR), including gross total resection (GTR), is one of the most important factors in predicting overall survival (OS) in IDH-wild type (IDH-WT) glioblastoma patients. Although GTR represents the complete resection of all visible contrast-enhancing parts of the tumor, imaging predictors of achieving this extent still need to be better understood.PurposeTo assess the impact of preoperative imaging phenotypes as defined by the VASARI feature set and tumoral volumetry to determine predictors of GTR in patients with IDH-WT glioblastoma.Material and MethodsThis retrospective, single-center study analyzed imaging characteristics based on the VASARI features in the preoperative scans of IDH-WT glioblastoma patients. Volumetric analysis was performed to determine associations with clinical outcomes. Univariate analysis was used to determine the association of VASARI features with GTR. A multivariate analysis model was used to determine predictors of GTR.ResultsGTR was achieved in 79/144 (54.8%) patients, near total resection in 15 (10.4%), and subtotal resection in 50 (34.7%) patients. Our results showed non-eloquent tumor regions (55% vs. 35%; P = 0.04) and thick margin of enhancement (56.1% vs. 43.9%; P = 0.04) were associated with GTR and ependymal extension (37% vs. 63%; P = 0.02). Deep white matter invasion (36.3% vs. 63.7%; P = 0.03) was significantly associated with non-gross total resection. Lower tumoral volumes were also associated with gross total resection (P < 0.01). After performing multivariate analysis, the thickness of the tumoral enhancing margins was correlated with GTR with an OR of 1.57 (95% CI=1.1-2.23). Furthermore, the volume of the enhancing component was significantly different according to EOR with a calculated OR of 0.95 (95% CI = 0.92-0.97; P < 0.01).ConclusionImaging characteristics on standard-of-care MRI can predict the rate of GTR in patients with IDH-WT glioblastomas. The thickness of enhancing margins predicts GTR after multivariate analysis. A diagnostic model that includes a combination of the discriminating depicted features on MRI and brain tumor volumetrics has an acceptable diagnostic performance with a specificity >90%.
切除范围(EOR),包括总切除(GTR),是预测idh -野生型(IDH-WT)胶质母细胞瘤患者总生存(OS)的最重要因素之一。虽然GTR代表了肿瘤所有可见增强部分的完全切除,但实现这一程度的影像学预测因素仍需要更好地了解。目的评估术前影像学表型(VASARI特征集定义)和肿瘤体积测定的影响,以确定IDH-WT胶质母细胞瘤患者GTR的预测因素。材料与方法本回顾性单中心研究分析了IDH-WT胶质母细胞瘤患者术前扫描VASARI特征的影像学特征。进行容积分析以确定与临床结果的关系。采用单因素分析确定VASARI特征与GTR的关系。采用多变量分析模型确定GTR的预测因子。结果144例患者中有79例(54.8%)实现了gtr,近全切除15例(10.4%),次全切除50例(34.7%)。我们的结果显示非雄辩的肿瘤区域(55% vs. 35%;P = 0.04)和厚边缘增强(56.1% vs. 43.9%;P = 0.04)与GTR和室管膜延伸相关(37% vs. 63%;p = 0.02)。深部白质侵袭(36.3% vs. 63.7%;P = 0.03)与非大体全切除显著相关。较小的肿瘤体积也与总切除相关(P < 90%)。
期刊介绍:
Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.