Department of Odontostomatological and Maxillo-Facial Sciences, Umberto I Hospital, Sapienza University, Via di Grottarossa, 00135, Rome, Italy.
NESMOS, Department of Neuroradiology, S. Andrea Hospital, Sapienza University, Rome, Italy.
J Neurooncol. 2018 Sep;139(2):455-460. doi: 10.1007/s11060-018-2887-4. Epub 2018 May 2.
The identification of prognostic biomarkers plays a pivotal role in the management of glioblastoma. The aim of this study was to assess the role of magnetic resonance dynamic susceptibility contrast imaging (DSC-MRI) with histogram analysis in the prognostic evaluation of patients suffering from glioblastoma.
Sixty-eight patients with newly diagnosed pathologically verified GBM were retrospectively evaluated. All patients underwent MRI investigations, including DSC-MRI, surgical procedure and received postoperative focal radiotherapy plus daily temozolomide (TMZ), followed by adjuvant TMZ therapy. Relative cerebral blood volume (rCBV) histograms were generated from a volume of interest covering the solid portions of the tumor and statistically evaluated for kurtosis, skewness, mean, median and maximum value of rCBV. To verify if histogram parameters could predict survival at 1 and 2 years, receiver operating characteristic (ROC) curves were obtained. Kaplan-Meier method was used to calculate patient's overall survival.
rCBV kurtosis and rCBV skewness showed significant differences between subjects surviving > 1 and > 2 years, According to ROC analysis, the rCBV kurtosis showed the best statistic performance compared to the other parameters; respectively, values of 1 and 2.45 represented an optimised cut-off point to distinguish subjects surviving over 1 or 2 years. Kaplan-Meier curves showed a significant difference between subjects with rCBV kurtosis values higher or lower than 1 (respectively 1021 and 576 days; Log-rank test: p = 0.007), and between subjects with rCBV kurtosis values higher or lower than 2.45 (respectively 802 and 408 days; Log-rank test: p = 0.001).
The histogram analysis of perfusion MRI proved to be a valid method to predict survival in patients affected by glioblastoma.
预后生物标志物的鉴定在胶质母细胞瘤的治疗中起着关键作用。本研究旨在评估磁共振动态磁敏感对比成像（DSC-MRI）直方图分析在预测胶质母细胞瘤患者预后中的作用。
回顾性评估了 68 例经病理证实的新诊断为胶质母细胞瘤的患者。所有患者均接受 MRI 检查，包括 DSC-MRI、手术，并接受术后局部放疗加每日替莫唑胺（TMZ）治疗，随后接受辅助 TMZ 治疗。从肿瘤实体部分的感兴趣区域生成相对脑血容量（rCBV）直方图，并对其峰度、偏度、rCBV 的平均值、中位数和最大值进行统计学评估。为了验证直方图参数是否可以预测 1 年和 2 年的生存率，获得了接收者操作特征（ROC）曲线。Kaplan-Meier 法用于计算患者的总生存率。
rCBV 峰度和 rCBV 偏度在存活时间>1 年和>2 年的患者之间存在显著差异。根据 ROC 分析，rCBV 峰度与其他参数相比具有最佳的统计学性能；分别为 1 和 2.45，代表了区分存活时间超过 1 年或 2 年的最佳截止点。Kaplan-Meier 曲线显示 rCBV 峰度值高于或低于 1（分别为 1021 和 576 天；对数秩检验：p=0.007）的患者之间以及 rCBV 峰度值高于或低于 2.45（分别为 802 和 408 天；对数秩检验：p=0.001）的患者之间存在显著差异。
灌注 MRI 的直方图分析被证明是预测胶质母细胞瘤患者生存的一种有效方法。
