低级别胶质瘤中动态磁敏感对比和动态对比增强磁共振成像参数与分子标志物状态的相关性：一项回顾性研究。
Association of dynamic susceptibility contrast- and dynamic contrast-enhanced magnetic resonance imaging parameters with molecular marker status in lower-grade gliomas: A retrospective study.
机构信息
Department of Radiology, 37991Yonsei University College of Medicine, Seoul, Korea.
出版信息
Neuroradiol J. 2023 Feb;36(1):49-58. doi: 10.1177/19714009221098369. Epub 2022 May 9.
PURPOSE
Molecular marker status is clinically relevant for treatment planning and predicting the prognosis of gliomas. This study aimed to assess whether quantitative imaging parameters from dynamic susceptibility contrast- (DSC-) and dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) can predict the molecular marker status of lower-grade gliomas (LGGs).
MATERIALS AND METHODS
Overall, 132 patients with LGGs who underwent DSC- and DCE-MRI were retrospectively enrolled. Statuses of relevant molecular markers including isocitrate dehydrogenase isoenzyme (IDH), 1p19q codeletion, epidermal growth factor receptor (EGFR), O6-methylguanine-DNA methyltransferase (MGMT), and telomerase reverse transcriptase (TERT) were collected. For each molecular marker, age, tumor diameter and location, and DSC- and DCE-MRI parameters, including the normalized cerebral blood volume (nCBV), volume transfer constant (Ktrans), rate transfer coefficient (Kep), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp), were compared. Multivariable logistic regression analyses were performed.
RESULTS
The nCBV was significantly lower in LGGs with IDH mutation ( = .001) and TERT mutation ( = .027) than those without these mutations. Ktrans ( = .034), Ve ( = .023), and Vp ( = .044) values were significantly lower in MGMT methylated LGGs than in MGMT unmethylated LGGs. Perfusion parameters were not significantly associated with EGFR amplification and 1p19q codeletion. Young age ( < .001) and small diameter ( = .001) were significantly associated with IDH mutation. The nCBV was independently associated with IDH status (AUC, 0.817; 95% CI: 0.739-0.894).
CONCLUSIONS
DSC- and DCE-MRI parameters demonstrated correlations with molecular markers of LGGs. Especially, the nCBV can be helpful in predicting the IDH mutation status.
目的
分子标志物状态与胶质瘤的治疗计划和预后预测密切相关。本研究旨在评估动态磁敏感对比（DSC）和动态对比增强（DCE）磁共振成像（MRI）的定量成像参数是否可以预测低级别胶质瘤（LGG）的分子标志物状态。
材料与方法
回顾性纳入了 132 例接受 DSC 和 DCE-MRI 检查的 LGG 患者。收集了与 IDH 同工酶（IDH）、1p19q 缺失、表皮生长因子受体（EGFR）、O6-甲基鸟嘌呤-DNA 甲基转移酶（MGMT）和端粒酶逆转录酶（TERT）等相关分子标志物的状态。对于每个分子标志物，比较了年龄、肿瘤直径和位置，以及 DSC 和 DCE-MRI 参数，包括归一化脑血容量（nCBV）、容积转移常数（Ktrans）、速率转移常数（Kep）、细胞外间隙体积分数（Ve）和血浆体积分数（Vp）。进行了多变量逻辑回归分析。
结果
与无这些突变的 LGG 相比，IDH 突变（ =.001）和 TERT 突变（ =.027）的 LGG 中 nCBV 明显更低。MGMT 甲基化的 LGG 中 Ktrans（ =.034）、Ve（ =.023）和 Vp（ =.044）值明显低于 MGMT 未甲基化的 LGG。灌注参数与 EGFR 扩增和 1p19q 缺失无显著相关性。年龄较小（ <.001）和肿瘤直径较小（ =.001）与 IDH 突变显著相关。nCBV 与 IDH 状态独立相关（AUC，0.817；95%CI：0.739-0.894）。
结论
DSC 和 DCE-MRI 参数与 LGG 的分子标志物具有相关性。特别是，nCBV 有助于预测 IDH 突变状态。
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