利用GRASP DCE-MRI评估胶质母细胞瘤的治疗反应

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-13 DOI:10.1016/j.ejrad.2025.112234

Björn Vankan , Vichyat Var , Nikki Rommers , Marios N. Psychogios , Ramona A. Todea

{"title":"利用GRASP DCE-MRI评估胶质母细胞瘤的治疗反应","authors":"Björn Vankan , Vichyat Var , Nikki Rommers , Marios N. Psychogios , Ramona A. Todea","doi":"10.1016/j.ejrad.2025.112234","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Following radiochemotherapy, glioblastoma patients often develop new or enlarging contrast-enhancing lesions, posing a critical challenge in distinguishing treatment-related changes (TRC) from tumor progression (TP). This study investigates the diagnostic accuracy of Golden Angle Radial Sparse Parallel Dynamic Contrast-Enhanced (GRASP DCE) MRI parameters derived from the signal intensity curve over time to discriminate TRC from TP.</div></div><div><h3>Methods</h3><div>Sixty-six glioblastoma patients, between 01/2017 and 12/2021, who underwent radiochemotherapy and developed new or enlarging contrast-enhancing lesions suspicious for TP, were analyzed. A diagnostic accuracy analysis using the area under the receiver operating characteristic curve (AUROC) assessed the effectiveness of GRASP DCE-MRI kinetic parameters in distinguishing TRC from TP.</div></div><div><h3>Results</h3><div>138 DCE-MRI scans were classified into TRC (n = 63) vs. TP group (n = 75) according to the lesion outcome on serial MRI follow-up and the pathology results. The peak enhancement percentage (PE%), the initial area under the curve 30 s (iAUC 30) and 60 s (iAUC 60) were consistently lower in the TRC than in the TP group. Both PE% (Sensitivity 89 % (95 % CI [83, 96]), Specificity 87 % (95 % CI [78, 95])) and iAUC30 (Sensitivity 80 % [71, 88]), Specificity 81 % [71, 91]) showed very high accuracy in discriminating TRC from TP. The best threshold for PE% to differentiate both groups was 40.7 %.</div></div><div><h3>Conclusion</h3><div>Peak enhancement derived from GRASP DCE-MRI demonstrated the highest accuracy in distinguishing treatment-related changes from tumor progression in glioblastoma. This reproducible, easily interpretable metric may aid neuroradiologists in evaluating new or enlarging lesions post-radiochemotherapy, improving clinical decision-making.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112234"},"PeriodicalIF":3.3000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment response assessment in glioblastoma with GRASP DCE-MRI\",\"authors\":\"Björn Vankan , Vichyat Var , Nikki Rommers , Marios N. Psychogios , Ramona A. Todea\",\"doi\":\"10.1016/j.ejrad.2025.112234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Following radiochemotherapy, glioblastoma patients often develop new or enlarging contrast-enhancing lesions, posing a critical challenge in distinguishing treatment-related changes (TRC) from tumor progression (TP). This study investigates the diagnostic accuracy of Golden Angle Radial Sparse Parallel Dynamic Contrast-Enhanced (GRASP DCE) MRI parameters derived from the signal intensity curve over time to discriminate TRC from TP.</div></div><div><h3>Methods</h3><div>Sixty-six glioblastoma patients, between 01/2017 and 12/2021, who underwent radiochemotherapy and developed new or enlarging contrast-enhancing lesions suspicious for TP, were analyzed. A diagnostic accuracy analysis using the area under the receiver operating characteristic curve (AUROC) assessed the effectiveness of GRASP DCE-MRI kinetic parameters in distinguishing TRC from TP.</div></div><div><h3>Results</h3><div>138 DCE-MRI scans were classified into TRC (n = 63) vs. TP group (n = 75) according to the lesion outcome on serial MRI follow-up and the pathology results. The peak enhancement percentage (PE%), the initial area under the curve 30 s (iAUC 30) and 60 s (iAUC 60) were consistently lower in the TRC than in the TP group. Both PE% (Sensitivity 89 % (95 % CI [83, 96]), Specificity 87 % (95 % CI [78, 95])) and iAUC30 (Sensitivity 80 % [71, 88]), Specificity 81 % [71, 91]) showed very high accuracy in discriminating TRC from TP. The best threshold for PE% to differentiate both groups was 40.7 %.</div></div><div><h3>Conclusion</h3><div>Peak enhancement derived from GRASP DCE-MRI demonstrated the highest accuracy in distinguishing treatment-related changes from tumor progression in glioblastoma. This reproducible, easily interpretable metric may aid neuroradiologists in evaluating new or enlarging lesions post-radiochemotherapy, improving clinical decision-making.</div></div>\",\"PeriodicalId\":12063,\"journal\":{\"name\":\"European Journal of Radiology\",\"volume\":\"190 \",\"pages\":\"Article 112234\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0720048X25003201\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25003201","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

摘要

目的：在放化疗后，胶质母细胞瘤患者经常出现新的或增大的对比增强病变，这对区分治疗相关改变（TRC）和肿瘤进展（TP）提出了关键挑战。本研究探讨了黄金角径向稀疏并行动态对比增强（GRASP DCE） MRI参数随时间变化的信号强度曲线对TRC和TP的诊断准确性。方法分析2017年1月至2021年12月期间66例接受放化疗并出现可疑TP新发或增大的对比增强病变的胶质母细胞瘤患者。一项使用受试者工作特征曲线下面积（AUROC）的诊断准确性分析评估了GRASP DCE-MRI动力学参数在区分TRC和TP方面的有效性。结果138例DCE-MRI扫描根据MRI连续随访病变结局及病理结果分为TRC组（n = 63）和TP组（n = 75）。TRC组的峰值增强率（PE%）、初始曲线下面积30 s （iAUC 30）和60 s （iAUC 60）均低于TP组。PE%(灵敏度89% （95% CI[83,96])，特异性87% （95% CI[78,95]）和iAUC30（灵敏度80%[71,88]），特异性81%[71,91]）在鉴别TRC和TP方面都显示出非常高的准确性。PE%区分两组的最佳阈值为40.7%。结论在胶质母细胞瘤的肿瘤进展中，GRASP dce mri的峰值增强显示出最高的准确性。这种可重复、易于解释的指标可以帮助神经放射学家评估放化疗后新发或扩大的病变，改善临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Treatment response assessment in glioblastoma with GRASP DCE-MRI

Purpose

Following radiochemotherapy, glioblastoma patients often develop new or enlarging contrast-enhancing lesions, posing a critical challenge in distinguishing treatment-related changes (TRC) from tumor progression (TP). This study investigates the diagnostic accuracy of Golden Angle Radial Sparse Parallel Dynamic Contrast-Enhanced (GRASP DCE) MRI parameters derived from the signal intensity curve over time to discriminate TRC from TP.

Methods

Sixty-six glioblastoma patients, between 01/2017 and 12/2021, who underwent radiochemotherapy and developed new or enlarging contrast-enhancing lesions suspicious for TP, were analyzed. A diagnostic accuracy analysis using the area under the receiver operating characteristic curve (AUROC) assessed the effectiveness of GRASP DCE-MRI kinetic parameters in distinguishing TRC from TP.

Results

138 DCE-MRI scans were classified into TRC (n = 63) vs. TP group (n = 75) according to the lesion outcome on serial MRI follow-up and the pathology results. The peak enhancement percentage (PE%), the initial area under the curve 30 s (iAUC 30) and 60 s (iAUC 60) were consistently lower in the TRC than in the TP group. Both PE% (Sensitivity 89 % (95 % CI [83, 96]), Specificity 87 % (95 % CI [78, 95])) and iAUC30 (Sensitivity 80 % [71, 88]), Specificity 81 % [71, 91]) showed very high accuracy in discriminating TRC from TP. The best threshold for PE% to differentiate both groups was 40.7 %.

Conclusion

Peak enhancement derived from GRASP DCE-MRI demonstrated the highest accuracy in distinguishing treatment-related changes from tumor progression in glioblastoma. This reproducible, easily interpretable metric may aid neuroradiologists in evaluating new or enlarging lesions post-radiochemotherapy, improving clinical decision-making.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.