DTI-p 图与 T/T-FLAIR 比较在评估胶质母细胞瘤患者术后高信号异常区域中的发现。
Findings of DTI-p maps in comparison with T/T-FLAIR to assess postoperative hyper-signal abnormal regions in patients with glioblastoma.
机构信息
Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Institute for Advanced Medical Imaging, Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
Department of Energy Engineering, Sharif University of Technology, Tehran, Iran.
出版信息
Cancer Imaging. 2018 Sep 18;18(1):33. doi: 10.1186/s40644-018-0166-4.
PURPOSE
The aim of this study was to compare diffusion tensor imaging (DTI) isotropic map (p-map) with current radiographically (T/T-FLAIR) methods based on abnormal hyper-signal size and location of glioblastoma tumor using a semi-automatic approach.
MATERIALS AND METHODS
Twenty-five patients with biopsy-proved diagnosis of glioblastoma participated in this study. T, T-FLAIR images and diffusion tensor imaging (DTI) were acquired 1 week before radiotherapy. Hyper-signal regions on T, T-FLAIR and DTI p-map were segmented by means of semi-automated segmentation. Manual segmentation was used as ground truth. Dice Scores (DS) were calculated for validation of semiautomatic method. Discordance Index (DI) and area difference percentage between the three above regions from the three modalities were calculated for each patient.
RESULTS
Area of abnormality in the p-map was smaller than the corresponding areas in the T and T-FLAIR images in 17 patients; with mean difference percentage of 30 ± 0.15 and 35 ± 0.15, respectively. Abnormal region in the p-map was larger than the corresponding areas in the T-FLAIR and T images in 4 patients; with mean difference percentage of 26 ± 0.17 and 29 ± 0.28, respectively. This region in the p-map was larger than the one in the T image and smaller than the one in the T-FLAIR image in 3 patients; with mean difference percentage of 34 ± 0.08 and 27 ± 0.06, respectively. Lack of concordance was observed ranged from 0.214-0.772 for T-FLAIR/p-map (average: 0.462 ± 0.18), 0.266-0.794 for T /p-map (average: 0.468 ± 0.13) and 0.123-0.776 for T/ T-FLAIR (average: 0.423 ± 0.2). These regions on three modalities were segmented using a semi-automatic segmentation method with over 86% sensitivity, 90% specificity and 89% dice score for three modalities.
CONCLUSION
It is noted that T, T-FLAIR and DTI p-maps represent different but complementary information for delineation of glioblastoma tumor margins. Therefore, this study suggests DTI p-map modality as a candidate to improve target volume delineation based on conventional modalities, which needs further investigations with follow-up data to be confirmed.
目的
本研究旨在比较扩散张量成像（DTI）各向同性图（p-map）与当前基于放射学（T/T-FLAIR）方法，采用半自动方法根据胶质母细胞瘤肿瘤的异常高信号大小和位置来比较弥散张量成像（DTI）各向同性图（p-map）与当前基于放射学（T/T-FLAIR）方法。
材料与方法
本研究纳入了 25 名经活检证实为胶质母细胞瘤的患者。在放疗前 1 周采集 T、T-FLAIR 图像和弥散张量成像（DTI）。通过半自动分割方法对 T、T-FLAIR 和 DTI p-map 上的高信号区域进行分割。手动分割作为金标准。计算 Dice 评分（DS）验证半自动方法的准确性。计算每位患者三种模态中三种区域之间的差异指数（DI）和面积差异百分比。
结果
17 名患者的 p-map 异常区域小于 T 和 T-FLAIR 图像中的相应区域；平均差异百分比分别为 30±0.15%和 35±0.15%。4 名患者的 p-map 异常区域大于 T-FLAIR 和 T 图像中的相应区域；平均差异百分比分别为 26±0.17%和 29±0.28%。3 名患者的 p-map 异常区域大于 T 图像而小于 T-FLAIR 图像中的相应区域；平均差异百分比分别为 34±0.08%和 27±0.06%。T-FLAIR/p-map 的一致性范围为 0.214-0.772（平均：0.462±0.18），T/p-map 的一致性范围为 0.266-0.794（平均：0.468±0.13），T/T-FLAIR 的一致性范围为 0.123-0.776（平均：0.423±0.2）。这三种模式下的这些区域均采用半自动分割方法进行分割，三种模式的灵敏度均超过 86%，特异性为 90%，Dice 评分 89%。
结论
本研究表明，T、T-FLAIR 和 DTI p-map 代表胶质母细胞瘤肿瘤边界的不同但互补的信息。因此，本研究建议将 DTI p-map 模式作为一种基于常规模式改善靶区勾画的候选方法，需要进一步的研究并结合随访数据进行确认。
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