Chong Insun, Ostrom Quinn, Khan Bilal, Dandachi Dima, Garg Naveen, Kotrotsou Aikaterini, Colen Rivka, Morón Fanny
Department of Radiology, Baylor College of Medicine, Houston, TX 77030, USA.
Section of Epidemiology and Population Sciences, Department of Medicine, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA.
Cancers (Basel). 2019 Oct 8;11(10):1506. doi: 10.3390/cancers11101506.
The ability to non-invasively predict outcomes and monitor treatment response in primary central nervous system lymphoma (PCNSL) is important as treatment regimens are constantly being trialed. The aim of this study was to assess the validity of using apparent diffusion coefficient (ADC) histogram values to predict Ki-67 expression, a tumor proliferation marker, and patient outcomes in PCNSL in both immunocompetent patients and patients living with HIV (PLWH). Qualitative PCNSL magnetic resonance imaging (MRI) characteristics from 93 patients (23 PLWH and 70 immunocompetent) were analyzed, and whole tumor segmentation was performed on the ADC maps. Quantitative histogram analyses of the segmentations were calculated. These measures were compared to PCNSL Ki-67 expression. Progression-free survival (PFS) and overall survival (OS) were analyzed via comparison to the International Primary Central Nervous System Lymphoma Collaboration Group Response Criteria. Associations between ADC measures and clinical outcomes were assessed using univariate and multivariate Cox proportional hazards models. Normalized ADC (nADC), nADC, nADC, nADC, and nADC values were significantly associated with a poorer OS. nADC, nADC, nADC, nADC, nADC, nADC, nADC inversely correlated with Ki-67 expression. OS was also significantly associated with lesion hemorrhage. PFS was not significantly associated with ADC values but with lesion hemorrhage. ADC histogram values and related parameters can predict the degree of tumor proliferation and patient outcomes for primary central nervous system lymphoma patients and in both immunocompetent patients and patients living with HIV.
在原发性中枢神经系统淋巴瘤（PCNSL）中，由于治疗方案不断处于试验阶段，非侵入性预测预后和监测治疗反应的能力很重要。本研究的目的是评估使用表观扩散系数（ADC）直方图值来预测Ki-67表达（一种肿瘤增殖标志物）以及免疫功能正常患者和艾滋病毒感染者（PLWH）中PCNSL患者预后的有效性。分析了93例患者（23例PLWH和70例免疫功能正常者）的定性PCNSL磁共振成像（MRI）特征，并在ADC图上进行了全肿瘤分割。对分割结果进行了定量直方图分析。将这些测量结果与PCNSL的Ki-67表达进行比较。通过与国际原发性中枢神经系统淋巴瘤协作组反应标准进行比较，分析无进展生存期（PFS）和总生存期（OS）。使用单变量和多变量Cox比例风险模型评估ADC测量值与临床结果之间的关联。标准化ADC（nADC）、nADC、nADC、nADC和nADC值与较差的OS显著相关。nADC、nADC、nADC、nADC、nADC、nADC、nADC与Ki-67表达呈负相关。OS也与病灶出血显著相关。PFS与ADC值无显著关联，但与病灶出血有关。ADC直方图值和相关参数可以预测原发性中枢神经系统淋巴瘤患者以及免疫功能正常患者和艾滋病毒感染者的肿瘤增殖程度和患者预后。
