胶质母细胞瘤患者中基于体素内不相干运动的直方图分析用于鉴别复发性肿瘤与治疗效果：初步临床经验
Histogram analysis of intravoxel incoherent motion for differentiating recurrent tumor from treatment effect in patients with glioblastoma: initial clinical experience.
作者信息
Kim H S, Suh C H, Kim N, Choi C-G, Kim S J
机构信息
From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
AJNR Am J Neuroradiol. 2014 Mar;35(3):490-7. doi: 10.3174/ajnr.A3719. Epub 2013 Aug 22.
BACKGROUND AND PURPOSE
Intravoxel incoherent motion can simultaneously measure diffusion and perfusion characteristics. Our aim was to determine whether the perfusion and diffusion parameters derived from intravoxel incoherent motion could act as imaging biomarkers for distinguishing recurrent tumor from treatment effect in patients with glioblastoma.
MATERIALS AND METHODS
Fifty-one patients with pathologically confirmed recurrent tumor (n = 31) or treatment effect (n = 20) were assessed by means of intravoxel incoherent motion MR imaging. The histogram cutoffs of the 90th percentiles for perfusion and normalized CBV and the 10th percentiles for diffusion and ADC were calculated and correlated with the final pathology results. A leave-one-out cross-validation was used to evaluate the diagnostic performance of our classifiers.
RESULTS
The mean 90th percentile for perfusion was significantly higher in the recurrent tumor group (0.084 ± 0.020) than in the treatment effect group (0.040 ± 0.010) (P < .001). The 90th percentile for perfusion provided a smaller number of patients within an overlap zone in which misclassifications can occur, compared with the 90th percentile for normalized CBV. The mean 10th percentile for diffusion was significantly lower in the recurrent tumor group than in the treatment effect group (P = .006). Receiver operating characteristic curve analyses showed the 90th percentile for perfusion to be a significant predictor for differentiation, with a sensitivity of 87.1% and a specificity of 95.0%. There was a significant positive correlation between the 90th percentiles for perfusion and normalized CBV (r = 0.674; P < .001).
CONCLUSIONS
A histogram analysis of intravoxel incoherent motion parameters can be used as a noninvasive imaging biomarker for differentiating recurrent tumor from treatment effect in patients with glioblastoma.
背景与目的
体素内不相干运动可同时测量扩散和灌注特征。我们的目的是确定从体素内不相干运动得出的灌注和扩散参数是否可作为成像生物标志物，用于区分胶质母细胞瘤患者的复发性肿瘤与治疗效果。
材料与方法
对51例经病理证实为复发性肿瘤（n = 31）或治疗效果（n = 20）的患者进行体素内不相干运动磁共振成像评估。计算灌注、标准化脑血容量的第90百分位数以及扩散和表观扩散系数的第10百分位数的直方图截断值，并将其与最终病理结果进行关联。采用留一法交叉验证来评估我们分类器的诊断性能。
结果
复发性肿瘤组的平均灌注第90百分位数（0.084±0.020）显著高于治疗效果组（0.040±0.010）（P <.001）。与标准化脑血容量的第90百分位数相比，灌注的第90百分位数在可能发生错误分类的重叠区域内的患者数量更少。复发性肿瘤组的平均扩散第10百分位数显著低于治疗效果组（P =.006）。受试者工作特征曲线分析显示，灌注的第90百分位数是区分两者的重要预测指标，敏感性为87.1%，特异性为95.0%。灌注和标准化脑血容量的第90百分位数之间存在显著正相关（r = 0.674；P <.001）。
结论
体素内不相干运动参数的直方图分析可作为一种非侵入性成像生物标志物，用于区分胶质母细胞瘤患者的复发性肿瘤与治疗效果。
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