Bilello Michel, Akbari Hamed, Da Xiao, Pisapia Jared M, Mohan Suyash, Wolf Ronald L, O'Rourke Donald M, Martinez-Lage Maria, Davatzikos Christos
Department of Radiology, University of Pennsylvania, Philadelphia, USA.
Department of Neurosurgery, University of Pennsylvania, Philadelphia, USA.
Neuroimage Clin. 2016 Mar 12;12:34-40. doi: 10.1016/j.nicl.2016.03.007. eCollection 2016.
In treating glioblastoma (GB), surgical and chemotherapeutic treatment guidelines are, for the most part, independent of tumor location. In this work, we compiled imaging data from a large cohort of GB patients to create statistical atlases illustrating the disease spatial frequency as a function of patient demographics as well as tumor characteristics.
Two-hundred-six patients with pathology-proven glioblastoma were included. Of those, 65 had pathology-proven recurrence and 113 had molecular subtype and genetic information. We used validated software to segment the tumors in all patients and map them from patient space into a common template. We then created statistical maps that described the spatial location of tumors with respect to demographics and tumor characteristics. We applied a chi-square test to determine whether pattern differences were statistically significant.
The most frequent location for glioblastoma in our patient population is the right temporal lobe. There are statistically significant differences when comparing patterns using demographic data such as gender (p = 0.0006) and age (p = 0.006). Small and large tumors tend to occur in separate locations (p = 0.0007). The tumors tend to occur in different locations according to their molecular subtypes (p < 10(- 6)). The classical subtype tends to spare the frontal lobes, the neural subtype tend to involve the inferior right frontal lobe. Although the sample size is limited, there was a difference in location according to EGFR VIII genotype (p < 10(- 4)), with a right temporal dominance for EFGR VIII negative tumors, and frontal lobe dominance in EGFR VIII positive tumors.
Spatial location of GB is an important factor that correlates with demographic factors and tumor characteristics, which should therefore be considered when evaluating a patient with GB and might assist in personalized treatment.
在治疗胶质母细胞瘤（GB）时，手术和化疗的治疗指南在很大程度上与肿瘤位置无关。在本研究中，我们收集了大量GB患者的影像数据，以创建统计图谱，说明疾病的空间频率与患者人口统计学特征以及肿瘤特征之间的关系。
纳入206例经病理证实的胶质母细胞瘤患者。其中，65例有病理证实的复发，113例有分子亚型和基因信息。我们使用经过验证的软件对所有患者的肿瘤进行分割，并将其从患者空间映射到一个通用模板中。然后，我们创建了统计图谱，描述了肿瘤相对于人口统计学特征和肿瘤特征的空间位置。我们应用卡方检验来确定模式差异是否具有统计学意义。
在我们的患者群体中，胶质母细胞瘤最常见的位置是右侧颞叶。使用性别（p = 0.0006）和年龄（p = 0.006）等人口统计学数据比较模式时，存在统计学显著差异。大小不同的肿瘤倾向于出现在不同的位置（p = 0.0007）。根据分子亚型，肿瘤倾向于出现在不同的位置（p < 10^(-6)）。经典亚型倾向于不累及额叶，神经亚型倾向于累及右下额叶。尽管样本量有限，但根据表皮生长因子受体VIII（EGFR VIII）基因型，肿瘤位置存在差异（p < 10^(-4)），EGFR VIII阴性肿瘤以右侧颞叶为主，EGFR VIII阳性肿瘤以额叶为主。
GB的空间位置是一个与人口统计学因素和肿瘤特征相关的重要因素，因此在评估GB患者时应予以考虑，这可能有助于个性化治疗。
