使用MRI直方图分析对异柠檬酸脱氢酶野生型胶质母细胞瘤中Ki-67表达水平进行无创预测：MRI形态学特征的比较与联合分析
Noninvasive prediction of Ki-67 expression level in IDH-wildtype glioblastoma using MRI histogram analysis: comparison and combination of MRI morphological features.
作者信息
Liang Qiang, Li Qiang, Liu Xianwang, Shao Shuqi, Pan Yawen, Wang Hongyu
机构信息
Department of Neurosurgery, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China.
Key Laboratory of Neurology of Gansu Province, Lanzhou University, Lanzhou, Gansu, China.
出版信息
Front Oncol. 2025 May 16;15:1577816. doi: 10.3389/fonc.2025.1577816. eCollection 2025.
PURPOSE
To assess and compare the effectiveness of magnetic resonance imaging (MRI) morphological features and MRI histogram analysis in noninvasively predicting Ki-67 expression levels in patients with IDH-wildtype glioblastoma.
METHODS
Forty-six cases of IDH-wildtype glioblastoma with measured Ki-67 expression levels from January 2022 to July 2024 were retrospectively collected. They were divided into Ki-67 low-level expression group (Ki-67<20%, n=20) and Ki-67 high-level expression group (Ki-67≥20%, n=26) according to Ki-67 expression level. MRI morphological features were assessed and recorded. MRI histogram analysis were performed on contrast-enhanced T1-weighted images. Differences between these parameters were compared between the two groups. The diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC). Spearman correlation was used to evaluate the relationship between histogram parameters and Ki-67 expression level.
RESULTS
Hemorrhage was more prone to occur in the Ki-67 high-level expression group (=0.017). The min, P01, P50, and P75 of IDH-wildtype glioblastoma Ki-67 high-level expression group were higher than those of the Ki-67 low-level expression group (<0.00357). There was a significant positive correlation between the min (=0.774), P01 (=0.729), P50 (=0.625), P75 (=0.591), and Ki-67 expression level (<0.05). The optimal diagnostic performance was obtained by combining MRI morphological features and histogram parameters, with an AUC of 0.867.
CONCLUSION
Both MRI morphological features and histogram parameters could predict the Ki-67 expression level in IDH-wildtype glioblastoma, and the combined model integrating MRI morphological features and histogram parameters can be an excellent imaging biomarker for noninvasively predicting Ki-67 expression levels in patients with IDH-wildtype glioblastoma.
目的
评估并比较磁共振成像（MRI）形态学特征和MRI直方图分析在无创预测异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤患者Ki-67表达水平中的有效性。
方法
回顾性收集2022年1月至2024年7月期间46例测量了Ki-67表达水平的IDH野生型胶质母细胞瘤病例。根据Ki-67表达水平将其分为Ki-67低表达组（Ki-67<20%，n=20）和Ki-67高表达组（Ki-67≥20%，n=26）。评估并记录MRI形态学特征。对增强T1加权图像进行MRI直方图分析。比较两组之间这些参数的差异。通过受试者工作特征曲线（AUC）下面积评估诊断性能。采用Spearman相关性分析评估直方图参数与Ki-67表达水平之间的关系。
结果
Ki-67高表达组更易发生出血（P=0.017）。IDH野生型胶质母细胞瘤Ki-67高表达组的最小值、P01、P50和P75高于Ki-67低表达组（P<0.00357）。最小值（P=0.774）、P01（P=0.729）、P50（P=0.625）、P75（P=0.591）与Ki-67表达水平之间存在显著正相关（P<0.05）。联合MRI形态学特征和直方图参数可获得最佳诊断性能，AUC为0.867。
结论
MRI形态学特征和直方图参数均可预测IDH野生型胶质母细胞瘤的Ki-67表达水平，整合MRI形态学特征和直方图参数的联合模型可成为无创预测IDH野生型胶质母细胞瘤患者Ki-67表达水平的优秀影像生物标志物。
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