Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Acad Radiol. 2024 Aug;31(8):3355-3365. doi: 10.1016/j.acra.2024.02.017. Epub 2024 Mar 4.
Homozygous deletion (HD) of CDKN2A/B holds important prognostic value in gliomas. This study aimed to explore the predictive potential of conventional MRI characteristics combined with dynamic contrast-enhanced MRI parameters in predicting CDKN2A/B HD status in gliomas.
Preoperative MRI data of 105 patients (69 without CDKN2A/B HD, and 36 with CDKN2A/B homozygous deletion) with gliomas were retrospectively collected. Conventional MRI features and dynamic contrast-enhanced-MRI qualitative parameter time-intensity curve type, quantitative parameters K, K, V, V, and iAUC were obtained. Logistic regression models for prediction of CDKN2A/B HD status were constructed in all types of gliomas and both subtypes of IDH-mutant and IDH-wild gliomas.
Multivariate analysis for all patients demonstrated that age (OR=1.103, p = 0.002) and K (OR=1.051, p < 0.001) independently predicted CDKN2A/B HD. In IDH-mutant subgroup, multivariate analysis results indicated that K (OR=1.098, p = 0.031) emerged as autonomous predictors of CDKN2A/B HD. In IDH-wild subgroup, age (OR=1.111, p = 0.002) and K (OR=1.032, p = 0.001) were independent predictors of CDKN2A/B HD according to the multivariate analysis. The areas under the receiver operating characteristic curve of the corresponding models were 0.90, 0.95 and 0.84, respectively.
K can serve as valuable predictive parameters for identifying CDKN2A/B HD status in all types of gliomas and both subtypes of IDH-mutant and IDH-wild gliomas. These findings provide a foundation for precise preoperative non-invasive diagnosis and personalized treatment approaches for glioma patients.
CDKN2A/B 纯合缺失(HD)在神经胶质瘤中具有重要的预后价值。本研究旨在探讨常规 MRI 特征与动态对比增强 MRI 参数联合预测神经胶质瘤中 CDKN2A/B HD 状态的预测潜力。
回顾性收集了 105 例神经胶质瘤患者(69 例无 CDKN2A/B HD,36 例 CDKN2A/B 纯合缺失)的术前 MRI 数据。获取常规 MRI 特征和动态对比增强 MRI 定性参数时间-强度曲线类型、定量参数 K、K、V、V 和 iAUC。在所有类型的神经胶质瘤和 IDH 突变型和 IDH 野生型神经胶质瘤的两种亚型中,构建了预测 CDKN2A/B HD 状态的逻辑回归模型。
所有患者的多变量分析表明,年龄(OR=1.103,p=0.002)和 K(OR=1.051,p<0.001)独立预测 CDKN2A/B HD。在 IDH 突变型亚组中,多变量分析结果表明 K(OR=1.098,p=0.031)是 CDKN2A/B HD 的自主预测因子。在 IDH 野生型亚组中,多变量分析表明年龄(OR=1.111,p=0.002)和 K(OR=1.032,p=0.001)是 CDKN2A/B HD 的独立预测因子。相应模型的受试者工作特征曲线下面积分别为 0.90、0.95 和 0.84。
K 可作为所有类型神经胶质瘤和 IDH 突变型和 IDH 野生型神经胶质瘤中识别 CDKN2A/B HD 状态的有价值的预测参数。这些发现为神经胶质瘤患者进行精确的术前无创诊断和个性化治疗方法提供了基础。