Vychopen Martin, Arlt Felix, Wilhelmy Florian, Seidel Clemens, Barrantes-Freer Alonso, Güresir Erdem, Wach Johannes
Department of Neurosurgery, University of Leipzig Medical Center, Leipzig, Germany.
Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany.
Front Surg. 2023 Dec 19;10:1303128. doi: 10.3389/fsurg.2023.1303128. eCollection 2023.
Spinal meningiomas (SM) account for 25%-46% of all primary spinal tumors and show an excellent long-term disease control in case of complete resection. Therefore, the postoperative functional outcome is of high importance. To date, reports on dorsally located SM are scarce. Moreover, the impact of radiomics shape features on the functional outcome after surgery for primary dorsal SMs has not been analyzed yet.
We retrospectively performed an analysis of shape-based radiomic features in 3D slicer software and quantified the tumor volume, surface area, sphericity, surface area to volume ratio and tumor canal ratio. Subsequently, we evaluated the correlation between the radinomic parameters and the postoperative outcome according to Modified Japanese Orthopedic Association (mJOA) score.
Between 2010 and 2022, we identified 24 Females and 2 Males operated on dorsal SMs in our institutional database. The most common SM localization was thoracic spine ( = 20), followed by cervical ( = 4), and lumbar ( = 2). The univariate analysis and the receiver operating characteristic (ROC) analysis showed a strong diagnostic performance of sphericity in the prediction of postoperative functional outcome based on mJOA score (AUC of 0.79, sphericity cut-of value 0.738; = 0.01). Subsequently, the patients were divided into two groups (mJOA improved vs. mJOA stable/worsened). Patients with improved mJOA score showed significantly higher sphericity (0.79 ± 0.1 vs. 0.70± 1.0; = 0.03). Finally, we divided the cohort based on sphericity (<0.738 and ≥0.738). The group with higher sphericity exhibited a significantly higher positive mJOA difference 3 months postoperatively (16.6 ± 1.4 vs. 14.8 ± 3.7; = 0.03).
In our study investigating primary sporadic dorsal SMs, we demonstrated that a higher degree of sphericity may be a positive predictor of postoperative improvement, as indicated by the mJOA score.
脊髓膜瘤(SM)占所有原发性脊髓肿瘤的25%-46%,若能完全切除,其长期疾病控制效果良好。因此,术后功能结果至关重要。迄今为止,关于背侧脊髓膜瘤的报道较少。此外,尚未分析影像组学形状特征对原发性背侧脊髓膜瘤手术后功能结果的影响。
我们回顾性地在3D Slicer软件中对基于形状的影像组学特征进行分析,并对肿瘤体积、表面积、球形度、表面积与体积比以及肿瘤椎管比进行量化。随后,我们根据改良日本骨科协会(mJOA)评分评估影像组学参数与术后结果之间的相关性。
2010年至2022年期间,我们在机构数据库中确定了24例接受背侧脊髓膜瘤手术的女性和2例男性。脊髓膜瘤最常见的定位是胸椎(=20例),其次是颈椎(=4例)和腰椎(=2例)。单因素分析和受试者操作特征(ROC)分析显示,基于mJOA评分,球形度在预测术后功能结果方面具有较强的诊断性能(AUC为0.79,球形度临界值为0.738;=0.01)。随后,将患者分为两组(mJOA改善组与mJOA稳定/恶化组)。mJOA评分改善的患者球形度显著更高(0.79±0.1对0.70±1.0;=0.03)。最后,我们根据球形度(<0.738和≥0.738)对队列进行分组。球形度较高的组术后3个月mJOA差异阳性显著更高(16.6±1.4对14.8±3.7;=0.03)。
在我们对原发性散发性背侧脊髓膜瘤的研究中,我们证明较高程度的球形度可能是术后改善的积极预测指标,如mJOA评分所示。