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T1 加权对比增强磁共振成像纹理分析可能预测非 Wnt 型/非 Sonic Hedgehog 型髓母细胞瘤患者的结局。

Texture Analysis of T1-Weighted Contrast-Enhanced Magnetic Resonance Imaging Potentially Predicts Outcomes of Patients with Non-Wingless-Type/Non-Sonic Hedgehog Medulloblastoma.

机构信息

Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, China.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

World Neurosurg. 2020 May;137:e27-e33. doi: 10.1016/j.wneu.2019.09.142. Epub 2019 Oct 4.

Abstract

OBJECTIVE

To investigate whether tumor texture features derived from preoperative T1-weighted magnetic resonance imaging (MRI) are associated with overall survival (OS) of patients with non-wingless-type (WNT)/non-sonic hedgehog (SHH) medulloblastoma.

METHODS

We retrospectively reviewed 38 patients with non-WNT/non-SHH (encompassing group 3 and group 4) medulloblastoma treated with surgery in our institution from 2013 to 2016. All patients were followed-up for at least 2 years or until death. Primary tumor traditional parameters were evaluated, and texture features were extracted from preoperative T1-weighted MRI, including 4 features from the histogram matrix and 6 textures from the gray-level co-occurrence matrix (GLCM). Texture features were dichotomized into 2 subgroups based on their optimal cutoff values obtained from receiver operating characteristics curve analysis. Two-year OS was compared between the dichotomized subgroups using the Kaplan-Meier analysis and log-rank test. Multivariate Cox regression analysis was performed to determine independent prognostic factors.

RESULTS

The therapy regimen was the only basic characteristic significantly related to 2-year OS (P = 0.015). Two features of the GLCM were shown to be significantly associated with 24-month OS. Multivariate Cox regression analysis revealed that GLCM homogeneity (adjusted hazard ratio, 0.145; P = 0.013) was an independent prognostic predictor for patients.

CONCLUSIONS

Texture analysis on T1-weighted contrast-enhanced MRI potentially serves as a prognostic predictor of survival for patients with non-WNT/non-SHH medulloblastoma.

摘要

目的

探讨术前 T1 加权磁共振成像(MRI)获得的肿瘤纹理特征是否与非无翅型(WNT)/非 sonic hedgehog(SHH)髓母细胞瘤患者的总生存期(OS)相关。

方法

我们回顾性分析了 2013 年至 2016 年在我院接受手术治疗的 38 例非 WNT/非 SHH(包括 3 组和 4 组)髓母细胞瘤患者。所有患者的随访时间均至少为 2 年或直至死亡。评估了原发肿瘤的传统参数,并从术前 T1 加权 MRI 中提取纹理特征,包括来自直方图矩阵的 4 个特征和来自灰度共生矩阵(GLCM)的 6 个纹理特征。基于受试者工作特征曲线分析获得的最佳截断值,将纹理特征分为 2 个亚组。使用 Kaplan-Meier 分析和对数秩检验比较 2 年 OS 之间的二分亚组。进行多变量 Cox 回归分析以确定独立的预后因素。

结果

治疗方案是唯一与 2 年 OS 显著相关的基本特征(P=0.015)。GLCM 的两个特征与 24 个月 OS 显著相关。多变量 Cox 回归分析显示,GLCM 同质性(调整后的危险比,0.145;P=0.013)是患者的独立预后预测因子。

结论

T1 加权对比增强 MRI 的纹理分析可能是预测非 WNT/非 SHH 髓母细胞瘤患者生存的预后预测因子。

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