成人型弥漫性胶质瘤中 IDH 和 CDKN2A/B 基因状态的临床可用且可重复的预测模型

IF 3.8 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
MeiLin Zhu , Fang Han , JiaHao Gao , Jing Yang , LongLin Yin , ZunGuo Du , JiaWen Zhang
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引用次数: 0

摘要

目的:异柠檬酸脱氢酶(IDH)和细胞周期蛋白依赖性激酶抑制剂(CDKN)2A/B状态在弥漫性胶质瘤中具有重要的预后价值。我们旨在利用临床可用且可重复的特征构建预测模型,以预测成人型弥漫性胶质瘤患者的IDH突变和CDKN2A/B同源缺失情况:这项双中心回顾性研究分析了 272 例成人型弥漫性胶质瘤患者(230 例为主要队列,42 例为外部验证队列)。两名放射科医生根据视觉可接受伦勃朗图像(VASARI)特征集对患者的图像进行了独立评估。最小绝对收缩和选择算子(LASSO)回归分析用于优化变量选择。多变量逻辑回归分析用于建立预测模型。校准图、接收器操作特征曲线(ROC)和决策曲线分析(DCA)用于验证模型。根据预测模型直观地绘制了提名图:两位放射科医生对 VASARI 特征的观察者间一致性非常好(κ范围为 0.813-1)。对于 IDH 突变预测模型,内部和外部验证集的曲线下面积(AUCs)为 0.88-0.96;对于 CDKN2A/B 同源缺失模型,内部和外部验证集的曲线下面积(AUCs)为 0.80-0.86。决策曲线显示,这两种预测模型都具有良好的净效益:基于 VASARI 和临床特征的预测模型为弥漫性胶质瘤患者的 IDH 和 CDKN2A/B 状态提供了可靠且有临床意义的术前预测。这些发现为成人型弥漫性胶质瘤患者的术前精确无创诊断和个性化治疗方法奠定了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinically Available and Reproducible Prediction Models for IDH and CDKN2A/B Gene Status in Adult-type Diffuse Gliomas

Purpose

Isocitrate dehydrogenase (IDH) and cyclin-dependent kinase inhibitor (CDKN) 2A/B status holds important prognostic value in diffuse gliomas. We aimed to construct prediction models using clinically available and reproducible characteristics for predicting IDH-mutant and CDKN2A/B homozygous deletion in adult-type diffuse glioma patients.

Materials and Methods

This retrospective, two-center study analysed 272 patients with adult-type diffuse glioma (230 for primary cohort and 42 for external validation cohort). Two radiologists independently assessed the patients’ images according to the Visually AcceSAble Rembrandt Images (VASARI) feature set. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to optimise variable selection. Multivariable logistic regression analysis was used to develop the prediction models. Calibration plots, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were used to validate the models. Nomograms were developed visually based on the prediction models.

Results

The interobserver agreement between the two radiologists for VASARI features was excellent (κ range, 0.813–1). For the IDH-mutant prediction model, the area under the curves (AUCs) was 0.88–0.96 in the internal and external validation sets, For the CDKN2A/B homozygous deletion model, the AUCs were 0.80–0.86 in the internal and external validation sets. The decision curves show that both prediction models had good net benefits.

Conclusion

The prediction models which basing on VASARI and clinical features provided a reliable and clinically meaningful preoperative prediction for IDH and CDKN2A/B status in diffuse glioma patients. These findings provide a foundation for precise preoperative non-invasive diagnosis and personalised treatment approaches for adult-type diffuse glioma patients.
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来源期刊
Academic Radiology
Academic Radiology 医学-核医学
CiteScore
7.60
自引率
10.40%
发文量
432
审稿时长
18 days
期刊介绍: Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.
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