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根据已知可预测抗血管内皮生长因子（VEGF）反应良好的扩散磁共振成像（MRI）表型对放化疗后胶质母细胞瘤进行的高级成像特征分析。

Advanced imaging characterization of post-chemoradiation glioblastoma stratified by diffusion MRI phenotypes known to predict favorable anti-VEGF response.

作者信息

Sanvito Francesco, Kryukov Irina, Yao Jingwen, Teraishi Ashley, Raymond Catalina, Gao John, Miller Cole, Nghiemphu Phioanh L, Lai Albert, Liau Linda M, Patel Kunal, Everson Richard G, Eldred Blaine S C, Prins Robert M, Nathanson David A, Salamon Noriko, Cloughesy Timothy F, Ellingson Benjamin M

机构信息

UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, Los Angeles, CA, USA.

Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

出版信息

J Neurooncol. 2025 Apr 14. doi: 10.1007/s11060-025-05019-8.

DOI:10.1007/s11060-025-05019-8

PMID:40227555

Abstract

PURPOSE

Recurrent glioblastomas showing a survival benefit from anti-VEGF agents are known to exhibit a distinct diffusion MRI phenotype. We aim to characterize advanced imaging features of this glioblastoma subset.

METHODS

MRI scans from 87 patients with IDH-wildtype glioblastoma were analyzed. All patients had completed standard chemoradiation and were anti-VEGF-naïve. Contrast-enhancing tumor segmentations were used to extract: the lowest peak of the double gaussian distribution of apparent diffusion coefficient values (ADC) calculated from diffusion MRI, relative cerebral blood flow (rCBV) values from perfusion MRI, MTR @ 3ppm from pH-weighted amine CEST MRI, quantitative T and T* relaxation times (qT and qT*), Tw subtraction map values, and contrast-enhancing tumor volume. Lesions were categorized as high- or low-ADC using a cutoff of 1240 µm/s, according to previous studies.

RESULTS

High-ADC lesions showed significantly lower rCBV (1.02 vs. 1.28, p = 0.0057), higher MTR @ 3ppm (2.36% vs. 2.10%, p = 0.0043), and higher qT (114.8 ms vs. 100.9 ms, p = 0.0094), compared to low-ADC lesions. No group differences were seen in contrast-enhancing tumor volume, Tw subtraction map values, and qT*, nor in clinical variables such as sex category, MGMT status, and EGFR status. Finally, no clear group-specific preferential locations were seen.

CONCLUSION

Post-chemoradiation glioblastomas with a diffusion MRI phenotype that is known to predict a favorable response to anti-VEGF (ADC ≥1240 µm/s) have distinct biological features, with different perfusion and metabolic characteristics, and T relaxation times.

摘要

目的

已知对抗血管内皮生长因子（VEGF）药物有生存获益的复发性胶质母细胞瘤表现出独特的扩散磁共振成像（MRI）表型。我们旨在描述该胶质母细胞瘤亚组的高级成像特征。

方法

分析了87例异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤患者的MRI扫描结果。所有患者均完成了标准的放化疗，且未接受过抗VEGF治疗。使用对比增强肿瘤分割来提取：从扩散MRI计算出的表观扩散系数（ADC）值的双高斯分布的最低峰值、灌注MRI的相对脑血流量（rCBV）值、pH加权胺化学交换饱和转移（CEST）MRI在3ppm处的磁化传递率（MTR）、定量T和T弛豫时间（qT和qT）、Tw减法图值以及对比增强肿瘤体积。根据先前的研究，使用1240μm²/s的临界值将病变分为高ADC或低ADC。

结果

与低ADC病变相比，高ADC病变的rCBV显著更低（1.02对1.28，p = 0.0057）、在3ppm处的MTR更高（2.36%对2.10%，p = 0.0043）以及qT更高（114.8 ms对100.9 ms，p = 0.0094）。在对比增强肿瘤体积、Tw减法图值和qT*方面，以及在性别类别、O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）状态和表皮生长因子受体（EGFR）状态等临床变量方面，未观察到组间差异。最后，未发现明确的组特异性偏好位置。