From the Department of Neurological Surgery (Z.K.E., M.L.O., J.N.B.), Gabriele Bartoli Brain Tumor Research Laboratory (Z.K.E., J.N.B., P.C.), Department of Pathology and Cell Biology (P.C.), and Department of Radiology (A.L., J.G.), Columbia University Medical Center, 710 W 168th St, Room B404, New York, NY 10032; Department of Radiology, Northwell Health, Manhasset, NY (C.I.H.); Department of Neurological Surgery, Oregon Health and Science University, Portland, OR (S.G.B.); and Department of Radiology, University of California-Irvine, Irvine, Calif (D.S.C.).
Radiology. 2018 Jun;287(3):965-972. doi: 10.1148/radiol.2017170790. Epub 2018 Jan 24.
Purpose To determine the effect that R132H mutation status of diffuse glioma has on extent of vascular dysregulation and extent of residual blood oxygen level-dependent (BOLD) abnormality after surgical resection. Materials and Methods This study was an institutional review board-approved retrospective analysis of an institutional database of patients, and informed consent was waived. From 2010 to 2017, 39 treatment-naïve patients with diffuse glioma underwent preoperative echo-planar imaging and BOLD functional magnetic resonance imaging. BOLD vascular dysregulation maps were made by identifying voxels with time series similar to tumor and dissimilar to healthy brain. The spatial overlap between tumor and vascular dysregulation was characterized by using the Dice coefficient, and areas of BOLD abnormality outside the tumor margins were quantified as BOLD-only fraction (BOF). Linear regression was used to assess effects of R132H status on the Dice coefficient, BOF, and residual BOLD abnormality after surgical resection. Results When compared with R132H wild-type (R132H-) gliomas, R132H-mutated (R132H+) gliomas showed greater spatial overlap between BOLD abnormality and tumor (mean Dice coefficient, 0.659 ± 0.02 [standard error] for R132H+ and 0.327 ± 0.04 for R132H-; P < .001), less BOLD abnormality beyond the tumor margin (mean BOF, 0.255 ± 0.03 for R132H+ and 0.728 ± 0.04 for R132H-; P < .001), and less postoperative BOLD abnormality (residual fraction, 0.046 ± 0.0047 for R132H+ and 0.397 ± 0.045 for R132H-; P < .001). Receiver operating characteristic curve analysis showed high sensitivity and specificity in the discrimination of R132H+ tumors from R132H- tumors with calculation of both Dice coefficient and BOF (area under the receiver operating characteristic curve, 0.967 and 0.977, respectively). Conclusion R132H mutation status is an important variable affecting the extent of tumor-associated vascular dysregulation and the residual vascular dysregulation after surgical resection. RSNA, 2018 Online supplemental material is available for this article.
确定弥漫性神经胶质瘤 R132H 突变状态对手术切除后血管失调程度和残留血氧水平依赖（BOLD）异常程度的影响。
这是一项经机构审查委员会批准的、对机构数据库中患者进行的回顾性分析，且豁免了知情同意。2010 年至 2017 年，39 例未经治疗的弥漫性神经胶质瘤患者接受了术前磁共振成像和 BOLD 功能磁共振成像检查。通过识别时间序列与肿瘤相似但与健康大脑不同的体素，制作 BOLD 血管失调图。通过 Dice 系数来描述肿瘤和血管失调之间的空间重叠程度，并量化肿瘤边缘以外的 BOLD 异常区域作为 BOLD 仅分数（BOF）。线性回归用于评估 R132H 状态对 Dice 系数、BOF 和手术后残留 BOLD 异常的影响。
与 R132H 野生型（R132H-）神经胶质瘤相比，R132H 突变型（R132H+）神经胶质瘤的 BOLD 异常与肿瘤之间的空间重叠更大（R132H+的平均 Dice 系数为 0.659±0.02[标准误差]，R132H-为 0.327±0.04；P<0.001），肿瘤边缘以外的 BOLD 异常更少（R132H+的平均 BOF 为 0.255±0.03，R132H-为 0.728±0.04；P<0.001），术后 BOLD 异常也更少（残留分数，R132H+为 0.046±0.0047，R132H-为 0.397±0.045；P<0.001）。接受者操作特征曲线分析显示，计算 Dice 系数和 BOF 对 R132H+肿瘤与 R132H-肿瘤的区分具有较高的灵敏度和特异性（接受者操作特征曲线下面积分别为 0.967 和 0.977）。
R132H 突变状态是影响肿瘤相关血管失调程度和手术切除后残留血管失调程度的重要变量。
RSNA，2018 年
在线补充材料可在本文中获取。
