Lopez-Rueda Antonio, Puig Josep, Thió-Henestrosa Santiago, Moreno-Negrete Javier Luis, Zwanzger Christian, Pujol Teresa, Aldecoa Iban, Pineda Estela, Valduvieco Izaskun, González José Juan, Oleaga Laura
Department of Radiology (CDI), Hospital Clínic de Barcelona, 08036 Barcelona, Spain.
Department of Radiology (IDI) and IDIBGI Hospital Universitari de Girona Doctor Josep Trueta, 17190 Girona, Spain.
Cancers (Basel). 2023 Jun 1;15(11):3026. doi: 10.3390/cancers15113026.
Glioblastoma often recurs after treatment. Bevacizumab increases progression-free survival in some patients with recurrent glioblastoma. Identifying pretreatment predictors of survival can help clinical decision making. Magnetic resonance texture analysis (MRTA) quantifies macroscopic tissue heterogeneity indirectly linked to microscopic tissue properties. We investigated the usefulness of MRTA in predicting survival in patients with recurrent glioblastoma treated with bevacizumab.
We evaluated retrospective longitudinal data from 33 patients (20 men; mean age 56 ± 13 years) who received bevacizumab on the first recurrence of glioblastoma. Volumes of contrast-enhancing lesions segmented on postcontrast T1-weighted sequences were co-registered on apparent diffusion coefficient maps to extract 107 radiomic features. To assess the performance of textural parameters in predicting progression-free survival and overall survival, we used receiver operating characteristic curves, univariate and multivariate regression analysis, and Kaplan-Meier plots.
Longer progression-free survival (>6 months) and overall survival (>1 year) were associated with lower values of major axis length (MAL), a lower maximum 2D diameter row (m2Ddr), and higher skewness values. Longer progression-free survival was also associated with higher kurtosis, and longer overall survival with higher elongation values. The model combining MAL, m2Ddr, and skewness best predicted progression-free survival at 6 months (AUC 0.886, 100% sensitivity, 77.8% specificity, 50% PPV, 100% NPV), and the model combining m2Ddr, elongation, and skewness best predicted overall survival (AUC 0.895, 83.3% sensitivity, 85.2% specificity, 55.6% PPV, 95.8% NPV).
Our preliminary analyses suggest that in patients with recurrent glioblastoma pretreatment, MRTA helps to predict survival after bevacizumab treatment.
胶质母细胞瘤在治疗后常复发。贝伐单抗可提高部分复发性胶质母细胞瘤患者的无进展生存期。识别生存的预处理预测指标有助于临床决策。磁共振纹理分析（MRTA）可间接量化与微观组织特性相关的宏观组织异质性。我们研究了MRTA在预测接受贝伐单抗治疗的复发性胶质母细胞瘤患者生存情况中的作用。
我们评估了33例（20例男性；平均年龄56±13岁）在胶质母细胞瘤首次复发时接受贝伐单抗治疗患者的回顾性纵向数据。在对比增强T1加权序列上分割的强化病变体积与表观扩散系数图进行配准，以提取107个影像组学特征。为评估纹理参数在预测无进展生存期和总生存期方面的性能，我们使用了受试者工作特征曲线、单变量和多变量回归分析以及Kaplan-Meier曲线。
更长的无进展生存期（>6个月）和总生存期（>1年）与短轴长度（MAL）值较低、最大二维直径行（m2Ddr）较低以及较高的偏度值相关。更长的无进展生存期还与较高的峰度相关，更长的总生存期与较高的伸长率值相关。结合MAL、m2Ddr和偏度的模型在6个月时对无进展生存期的预测效果最佳（AUC 0.886，敏感性100%，特异性77.8%，阳性预测值50%，阴性预测值100%），结合m2Ddr、伸长率和偏度的模型对总生存期的预测效果最佳（AUC 0.895，敏感性83.3%，特异性85.2%，阳性预测值55.6%，阴性预测值95.8%）。
我们的初步分析表明，对于复发性胶质母细胞瘤患者，预处理时的MRTA有助于预测贝伐单抗治疗后的生存情况。
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