Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610072, China.
Cereb Cortex. 2024 Jan 14;34(1). doi: 10.1093/cercor/bhad491.
Systemic infiltration is a hallmark of diffuse midline glioma pathogenesis, which can trigger distant disturbances in cortical structure. However, the existence and effects of these changes have been underexamined. This study aimed to investigate whole-brain cortical myelin and thickness alternations induced by diffuse midline glioma. High-resolution T1- and T2-weighted images were acquired from 90 patients with diffuse midline glioma with H3 K27-altered and 64 patients with wild-type and 86 healthy controls. Cortical thickness and myelin content was calculated using Human Connectome Project pipeline. Significant differences in cortical thickness and myelin content were detected among groups. Short-term survival prediction model was constructed using automated machine learning. Compared with healthy controls, diffuse midline glioma with H3 K27-altered patients showed significantly reduced cortical myelin in bilateral precentral gyrus, postcentral gyrus, insular, parahippocampal gyrus, fusiform gyrus, and cingulate gyrus, whereas diffuse midline glioma with H3 K27 wild-type patients exhibited well-preserved myelin content. Furtherly, when comparing diffuse midline glioma with H3 K27-altered and diffuse midline glioma with H3 K27 wild-type, the decreased cortical thickness in parietal and occipital regions along with demyelination in medial orbitofrontal cortex was observed in diffuse midline glioma with H3 K27-altered. Notably, a combination of cortical features and tumor radiomics allowed short-term survival prediction with accuracy 0.80 and AUC 0.84. These findings may aid clinicians in tailoring therapeutic approaches based on cortical characteristics, potentially enhancing the efficacy of current and future treatment modalities.
系统性浸润是弥漫性中线胶质瘤发病机制的一个标志，它可以引发皮质结构的远处紊乱。然而，这些变化的存在和影响尚未得到充分研究。本研究旨在探讨弥漫性中线胶质瘤引起的全脑皮质髓鞘和厚度变化。从 90 名 H3 K27 改变的弥漫性中线胶质瘤患者、64 名野生型和 86 名健康对照者中获得高分辨率 T1 和 T2 加权图像。使用 Human Connectome Project 管道计算皮质厚度和髓鞘含量。组间存在显著的皮质厚度和髓鞘含量差异。使用自动化机器学习构建短期生存预测模型。与健康对照组相比，H3 K27 改变的弥漫性中线胶质瘤患者双侧中央前回、中央后回、岛叶、海马旁回、梭状回和扣带回的皮质髓鞘明显减少，而 H3 K27 野生型弥漫性中线胶质瘤患者的髓鞘含量保持完好。此外，当比较 H3 K27 改变的弥漫性中线胶质瘤和 H3 K27 野生型的弥漫性中线胶质瘤时，在 H3 K27 改变的弥漫性中线胶质瘤中观察到顶叶和枕叶区域皮质厚度减少以及内侧眶额皮质脱髓鞘。值得注意的是，皮质特征与肿瘤放射组学的结合可以实现短期生存预测，准确率为 0.80，AUC 为 0.84。这些发现可能有助于临床医生根据皮质特征定制治疗方法，从而提高当前和未来治疗方式的疗效。
