He Lei, Fei Fan, Zhou Chengzhi, Bai Xiaoyan, Yu Shuqing, Wang Lei, Xu Ruxiang, Liu Hanjie
Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Neurooncol Adv. 2025 Feb 8;7(1):vdaf035. doi: 10.1093/noajnl/vdaf035. eCollection 2025 Jan-Dec.
Approximately 8.94%-44.44% of nonenhancing adult-type diffuse gliomas are identified as glioblastomas. Our purpose is to develop a nomogram that can predict glioblastomas from nonenhancing adult-type diffuse gliomas.
Nonenhancing adult-type diffuse gliomas were collected from Beijing Tiantan Hospital and TCIA public database. Univariate and multivariate logistic regression were performed to screen features on the training set. The features with < .05 in multivariate logistic regression were used to establish the prediction model. The testing and validation sets were used to test the model.
A total of 557 and 67 nonenhancing adult-type diffuse gliomas were collected from Beijing Tiantan Hospital and TCIA, respectively. The T2-FLAIR mismatch sign exhibited 100% specificity but low sensitivity (<30%) in ruling out glioblastoma. Age, tumor location, rADC, and rADC were identified as independent predictors and employed for developing the prediction model. The AUC of the model was 0.901, 0.861, and 0.945 in the training, testing, and validation set, respectively. The best cutoff value of nomoscore was 138.5, which achieved sensitivity of 0.935, 0.714, and 0.895, specificity of 0.777, 0.782, and 0.8775 in the training, testing, and validation sets, respectively. Survival analysis shown that patients with nomoscore above 138.5 had significantly poorer survival time than those with scores below 138.5.
Positive T2-FLAIR mismatch sign can effectively rule out glioblastoma in nonenhancing adult-type diffuse gliomas with high specificity. Nonenhancing adult-type diffuse gliomas with nomoscore above 138.5 are highly suspicious for glioblastoma or nonglioblastoma with a poor prognosis.
约8.94%-44.44%的无强化成人型弥漫性胶质瘤被诊断为胶质母细胞瘤。我们的目的是开发一种列线图，能够从无强化成人型弥漫性胶质瘤中预测胶质母细胞瘤。
从北京天坛医院和TCIA公共数据库收集无强化成人型弥漫性胶质瘤。在训练集上进行单因素和多因素逻辑回归以筛选特征。多因素逻辑回归中P<0.05的特征用于建立预测模型。测试集和验证集用于检验模型。
分别从北京天坛医院和TCIA收集了557例和67例无强化成人型弥漫性胶质瘤。T2-FLAIR不匹配征在排除胶质母细胞瘤时特异性为100%，但敏感性较低（<30%）。年龄、肿瘤位置、相对表观扩散系数（rADC）等被确定为独立预测因素，并用于构建预测模型。该模型在训练集、测试集和验证集中的曲线下面积（AUC）分别为0.901、0.861和0.945。列线图评分的最佳截断值为138.5，在训练集、测试集和验证集中的敏感性分别为0.935、0.714和0.895，特异性分别为0.777、0.782和0.8775。生存分析显示，列线图评分高于138.5的患者生存时间显著短于评分低于138.5的患者。
T2-FLAIR不匹配征阳性可有效排除无强化成人型弥漫性胶质瘤中的胶质母细胞瘤，特异性高。列线图评分高于138.5的无强化成人型弥漫性胶质瘤高度怀疑为胶质母细胞瘤或预后不良的非胶质母细胞瘤。
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