Xing Zhen, Wang Cong, Yang Wen, She Dejun, Yang Xiefeng, Cao Dairong
Department of Radiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, Fujian, China.
Heliyon. 2024 Apr 26;10(9):e30411. doi: 10.1016/j.heliyon.2024.e30411. eCollection 2024 May 15.
To assess the feasibility of multiparametric magnetic resonance imaging in predicting tumor recurrence in nonenhancing peritumoral regions in patients with glioblastoma at baseline.
Fifty-eight patients with recurrent glioblastoma underwent multiparametric magnetic resonance imaging, including T2-weighted fluid-attenuated inversion recovery, diffusion-weighted imaging, and dynamic susceptibility contrast perfusion-weighted imaging. Nonenhancing peritumoral regions with glioblastoma recurrence were identified by coregistering preoperative and post-recurrent magnetic resonance images. Regions of interest were placed in nonenhancing peritumoral regions with and without tumor recurrence to calculate the apparent diffusion coefficient value, and relative ratios of T2-weighted fluid-attenuated inversion recovery signal intensity, apparent diffusion coefficient, and cerebral blood volume values.
Significant lower relative T2-weighted fluid-attenuated inversion recovery signal intensity, apparent diffusion coefficient, and relative apparent diffusion coefficient but higher relative cerebral blood volume values were found in the nonenhancing peritumoral regions with tumor recurrence than without recurrence (all < 0.05). The threshold values ≥ 0.89 for relative cerebral blood volume provide the optimal performance for predicting the nonenhancing peritumoral regions with future tumor recurrence, with the sensitivity, specificity, and accuracy of 84.7%, 83.6%, and 85.8%, respectively. The combination of relative T2-weighted fluid-attenuated inversion recovery signal intensity, apparent diffusion coefficient, and relative cerebral blood volume can provide better predictive performance than relative cerebral blood volume ( = 0.015).
The combined use of T2-weighted fluid-attenuated inversion recovery, diffusion-weighted imaging, and dynamic susceptibility contrast perfusion-weighted imaging can effectively estimate the risk of future tumor recurrence at baseline.
评估多参数磁共振成像在预测胶质母细胞瘤患者基线时肿瘤在瘤周无强化区域复发的可行性。
58例复发性胶质母细胞瘤患者接受了多参数磁共振成像检查，包括T2加权液体衰减反转恢复序列、扩散加权成像和动态磁敏感对比灌注加权成像。通过术前和复发后磁共振图像配准来识别胶质母细胞瘤复发的瘤周无强化区域。在有和无肿瘤复发的瘤周无强化区域放置感兴趣区，以计算表观扩散系数值以及T2加权液体衰减反转恢复信号强度、表观扩散系数和脑血容量值的相对比值。
与无复发的瘤周无强化区域相比，有肿瘤复发的瘤周无强化区域的相对T2加权液体衰减反转恢复信号强度、表观扩散系数和相对表观扩散系数显著更低，但相对脑血容量值更高（均P<0.05）。相对脑血容量≥0.89的阈值对预测未来肿瘤复发的瘤周无强化区域具有最佳性能，敏感性、特异性和准确性分别为84.7%、83.6%和85.8%。相对T2加权液体衰减反转恢复信号强度、表观扩散系数和相对脑血容量的联合应用比相对脑血容量能提供更好的预测性能（P=0.015）。
联合使用T2加权液体衰减反转恢复序列、扩散加权成像和动态磁敏感对比灌注加权成像能够有效估计基线时未来肿瘤复发的风险。
