Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.
Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.
Magn Reson Imaging. 2023 Dec;104:23-28. doi: 10.1016/j.mri.2023.09.004. Epub 2023 Sep 19.
To evaluation of diffusion heterogeneity and vascular perfusion in tumor and peritumoral areas for prognostic prediction in high-grade glioma (HGG, WHO III/IV grade).
Forty patients with HGG underwent diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), and arterial spin labeling (ASL) MRI before operation. After normalization, the parameters were divided into diffusion heterogeneity parameters (rD, rMD, rMK, rKr, rKa) and vascular perfusion parameters (rD*, rF, rCBF). Univariate and multivariate Cox regression analyses were used to evaluate associations between overall survival (OS) and the above parameters, clinical factors, and IDH1 status. The Mann-Whitney test was used to evaluate differences in the parameters between different IDH1 states.
In the univariate Cox regression analysis, OS was significantly associated with tumor resection range, IDH1 status, tumor heterogeneity parameters (rD, rMD, rMK, rKr, rKa), and rCBF in tumor area(all p < 0.05). In addition, rD and rCBF measured in the peritumoral region were also predictors of poor OS (both p < 0.01). Multivariate Cox regression analysis indicated that rMK in the tumor area and rCBF in the peritumoral area (hazard ratio = 7.900 and 5.466, respectively, for each 0.1 increase in the normalized value) were independent predictors of OS.
The rMK of tumor area and rCBF of peritumoral area had independent predictive value for OS in patients with HGG.
This study explored useful imaging biomarkers from the diffusion heterogeneity and vascular perfusion of tumor and peritumoral areas in HGG, which is useful to help clinician to make precise therapeutic plans, and predict the prognostic for glioma patients.
评估高级别胶质瘤（HGG，WHO Ⅲ/Ⅳ级）肿瘤及瘤周区的扩散异质性和血管灌注，以进行预后预测。
40 例 HGG 患者于术前接受了扩散峰度成像（DKI）、体素内不相干运动（IVIM）和动脉自旋标记（ASL）MRI 检查。归一化后，参数分为扩散异质性参数（rD、rMD、rMK、rKr、rKa）和血管灌注参数（rD*、rF、rCBF）。采用单因素和多因素 Cox 回归分析评估总生存期（OS）与上述参数、临床因素和 IDH1 状态之间的相关性。采用 Mann-Whitney 检验评估不同 IDH1 状态下参数的差异。
在单因素 Cox 回归分析中，OS 与肿瘤切除范围、IDH1 状态、肿瘤异质性参数（rD、rMD、rMK、rKr、rKa）以及肿瘤区 rCBF 显著相关（均 p<0.05）。此外，瘤周区的 rD 和 rCBF 也是 OS 不良的预测因素（均 p<0.01）。多因素 Cox 回归分析表明，肿瘤区的 rMK 和瘤周区的 rCBF（归一化值每增加 0.1，风险比分别为 7.900 和 5.466）是 OS 的独立预测因素。
肿瘤区的 rMK 和瘤周区的 rCBF 对 HGG 患者的 OS 具有独立的预测价值。
本研究从 HGG 肿瘤及瘤周区的扩散异质性和血管灌注方面探索了有用的影像生物标志物，有助于临床医生制定精确的治疗计划，并预测胶质瘤患者的预后。
