Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
World Neurosurg. 2020 May;137:e27-e33. doi: 10.1016/j.wneu.2019.09.142. Epub 2019 Oct 4.
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.
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.
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.
Texture analysis on T1-weighted contrast-enhanced MRI potentially serves as a prognostic predictor of survival for patients with non-WNT/non-SHH medulloblastoma.
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。
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。
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。
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。