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Chilaca-Rosas MF, Contreras-Aguilar MT, Garcia-Lezama M, Salazar-Calderon DR, Vargas-Del-Angel RG, Moreno-Jimenez S, Piña-Sanchez P, Trejo-Rosales RR, Delgado-Martinez FA, Roldan-Valadez E. Identification of Radiomic Signatures in Brain MRI Sequences T1 and T2 That Differentiate Tumor Regions of Midline Gliomas with H3.3K27M Mutation. Diagnostics (Basel) 2023; 13:2669. [PMID: 37627927 PMCID: PMC10453217 DOI: 10.3390/diagnostics13162669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Radiomics refers to the acquisition of traces of quantitative features that are usually non-perceptible to human vision and are obtained from different imaging techniques and subsequently transformed into high-dimensional data. Diffuse midline gliomas (DMG) represent approximately 20% of pediatric CNS tumors, with a median survival of less than one year after diagnosis. We aimed to identify which radiomics can discriminate DMG tumor regions (viable tumor and peritumoral edema) from equivalent midline normal tissue (EMNT) in patients with the positive H3.F3K27M mutation, which is associated with a worse prognosis. PATIENTS AND METHODS This was a retrospective study. From a database of 126 DMG patients (children, adolescents, and young adults), only 12 had H3.3K27M mutation and available brain magnetic resonance DICOM file. The MRI T1 post-gadolinium and T2 sequences were uploaded to LIFEx software to post-process and extract radiomic features. Statistical analysis included normal distribution tests and the Mann-Whitney U test performed using IBM SPSS® (Version 27.0.0.1, International Business Machines Corp., Armonk, NY, USA), considering a significant statistical p-value ≤ 0.05. RESULTS EMNT vs. Tumor: From the T1 sequence 10 radiomics were identified, and 14 radiomics from the T2 sequence, but only one radiomic identified viable tumors in both sequences (p < 0.05) (DISCRETIZED_Q1). Peritumoral edema vs. EMNT: From the T1 sequence, five radiomics were identified, and four radiomics from the T2 sequence. However, four radiomics could discriminate peritumoral edema in both sequences (p < 0.05) (CONVENTIONAL_Kurtosis, CONVENTIONAL_ExcessKurtosis, DISCRETIZED_Kurtosis, and DISCRETIZED_ExcessKurtosis). There were no radiomics useful for distinguishing tumor tissue from peritumoral edema in both sequences. CONCLUSIONS Less than 5% of the radiomic characteristics identified tumor regions of medical-clinical interest in T1 and T2 sequences of conventional magnetic resonance imaging. The first-order and second-order radiomic features suggest support to investigators and clinicians for careful evaluation for diagnosis, patient classification, and multimodality cancer treatment planning.
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Affiliation(s)
- Maria-Fatima Chilaca-Rosas
- Radiotherapy Department, Hospital de Oncología, Centro Medico Nacional Siglo XXI, Instituto Mexicano Del Seguro Social, Mexico City 06720, Mexico; (M.-F.C.-R.); (D.-R.S.-C.)
| | - Manuel-Tadeo Contreras-Aguilar
- Radiotherapy Department, Hospital de Oncología, Centro Medico Nacional Siglo XXI, Instituto Mexicano Del Seguro Social, Mexico City 06720, Mexico; (M.-F.C.-R.); (D.-R.S.-C.)
| | - Melissa Garcia-Lezama
- Directorate of Research, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City 06720, Mexico;
| | - David-Rafael Salazar-Calderon
- Radiotherapy Department, Hospital de Oncología, Centro Medico Nacional Siglo XXI, Instituto Mexicano Del Seguro Social, Mexico City 06720, Mexico; (M.-F.C.-R.); (D.-R.S.-C.)
| | | | - Sergio Moreno-Jimenez
- Neurological Center, Neurosurgery Department of National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico;
- Neurological Center, Neurosurgery Department of American British Cowdray Medical Center, Mexico City 01120, Mexico
| | - Patricia Piña-Sanchez
- Oncology Diagnostic, Unidad de Investigacion Medica en Enfermedades Oncologicas U.I.M.E.O, Hospital de Oncología, Centro Medico Nacional Siglo XXI, Instituto Mexicano Del Seguro Social, Mexico City 06720, Mexico;
| | - Raul-Rogelio Trejo-Rosales
- Medical Oncology, Hospital de Oncología, Centro Medico Nacional Siglo XXI, Instituto Mexicano Del Seguro Social, Mexico City 06720, Mexico;
| | - Felipe-Alfredo Delgado-Martinez
- Magnetic Resonance Service, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | - Ernesto Roldan-Valadez
- Directorate of Research, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City 06720, Mexico;
- Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119992 Moscow, Russia
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Diagnostic Performance of Selected MRI-Derived Radiomics Able to Discriminate Progression-Free and Overall Survival in Patients with Midline Glioma and the H3F3AK27M Mutation. Diagnostics (Basel) 2023; 13:diagnostics13050849. [PMID: 36899993 PMCID: PMC10001394 DOI: 10.3390/diagnostics13050849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Radiomics refers to a recent area of knowledge that studies features extracted from different imaging techniques and subsequently transformed into high-dimensional data that can be associated with biological events. Diffuse midline gliomas (DMG) are one of the most devastating types of cancer, with a median survival of approximately 11 months after diagnosis and 4-5 months after radiological and clinical progression. METHODS A retrospective study. From a database of 91 patients with DMG, only 12 had the H3.3K27M mutation and brain MRI DICOM files available. Radiomic features were extracted from MRI T1 and T2 sequences using LIFEx software. Statistical analysis included normal distribution tests and the Mann-Whitney U test, ROC analysis, and calculation of cut-off values. RESULTS A total of 5760 radiomic values were included in the analyses. AUROC demonstrated 13 radiomics with statistical significance for progression-free survival (PFS) and overall survival (OS). Diagnostic performance tests showed nine radiomics with specificity for PFS above 90% and one with a sensitivity of 97.2%. For OS, 3 out of 4 radiomics demonstrated between 80 and 90% sensitivity. CONCLUSIONS Several radiomic features demonstrated statistical significance and have the potential to further aid DMG diagnostic assessment non-invasively. The most significant radiomics were first- and second-order features with GLCM texture profile, GLZLM_GLNU, and NGLDM_Contrast.
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Li H, Duan Y, Liu N, Dong J, Liang Y, Ju R. Value of DWI Combined with Magnetic Resonance Spectroscopy in the Differential Diagnosis between Recurrent Glioma and Radiation Injury: A Meta-Analysis. Int J Clin Pract 2022; 2022:1629570. [PMID: 36380750 PMCID: PMC9626199 DOI: 10.1155/2022/1629570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
To analyse the value of the apparent diffusion coefficient (ADC) in diffusion-weighted imaging (DWI) and the choline (Cho)/creatine (Cr) ratio and Cho/N-acetyl-aspartate (NAA) ratio in magnetic resonance spectroscopy (MRS) in the differential diagnosis between recurrent glioma and radiation injury. Chinese and English studies related to the diagnosis of recurrent glioma and radiation injury using DWI and MRS and published before 15 October 2022 were retrieved from PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, China Biomedical Literature Database, VIP Journal Database, and Wanfang Database for a meta-analysis. A total of 11 articles were included in this study. ADC was lower in the recurrent glioma group than in the radiation injury group (standardized mean difference = -1.29, 95% confidence interval (CI) (-1.87, -0.71), P < 0.001). The Cho/Cr ratio was higher in the recurrent glioma group than in the radiation injury group (weighted mean difference = 0.65, 95% CI (0.40, 0.90), and P < 0.001). The Cho/NAA ratio was higher in the recurrent glioma group than in the radiation injury group, as evidenced by the sensitivity analysis. The sensitivity and specificity of the Cho/Cr ratio were 0.85 (0.73-0.92) and 0.82 (0.67-0.91), respectively, and the area under the curve was 0.86. The sensitivity and specificity of the Cho/NAA ratio were 0.82 (0.66-0.91) and 0.94 (0.69-0.99), respectively, and the area under the curve was 0.93. This meta-analysis showed that ADC, Cho/Cr, and Cho/NAA ratios all had high sensitivity and specificity. Therefore, DWI combined with MRS can effectively improve the diagnosis of recurrent glioma and radiation injury.
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Affiliation(s)
- Hongyi Li
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang 110016, China
- Department of Radiology, The People's Hospital of China Medical University, Shenyang 110016, China
| | - Yang Duan
- Department of Radiology, The General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Na Liu
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang 110016, China
- Department of Radiology, The People's Hospital of China Medical University, Shenyang 110016, China
| | - Junyi Dong
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang 110016, China
- Department of Radiology, The People's Hospital of China Medical University, Shenyang 110016, China
| | - Yuanzi Liang
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang 110016, China
- Department of Radiology, The People's Hospital of China Medical University, Shenyang 110016, China
| | - Ronghui Ju
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang 110016, China
- Department of Radiology, The People's Hospital of China Medical University, Shenyang 110016, China
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Latysheva A, Geier OM, Hope TR, Brunetti M, Micci F, Vik-Mo EO, Emblem KE, Server A. Diagnostic utility of Restriction Spectrum Imaging in the characterization of the peritumoral brain zone in glioblastoma: Analysis of overall and progression-free survival. Eur J Radiol 2020; 132:109289. [PMID: 33002815 DOI: 10.1016/j.ejrad.2020.109289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/07/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE We studied the ability of Restriction Spectrum Imaging (RSI), a novel advanced diffusion imaging technique, to estimate levels of cellularity in different glioblastoma regions, evaluated their prognostic value compared with established clinical diffusion metrics such as fractional anisotropy (FA) and mean diffusivity (MD). METHODS Forty-two patients with untreated glioblastoma, IDH-wildtype, were examined with an advanced MRI tumor protocol. The region of interest (ROI) was obtained from the contrast-enhancing part of tumor and the peritumoral brain zones and then co-registered with RSI-cellularity index, FA and MD maps. Histogram parameters of diffusion metrics were assessed for all ROI locations and compared to MGMT promoter methylation status and survival. The ability of RSI-cellularity index, FA, and MD to stratify survival and were assessed by Cox proportional hazard regression, adjusted for significant clinical predictors. RESULTS The highest RSI-cellularity index was measured in contrast-enhancing tumor core with a negative gradient from tumor core to the periphery of peritumoral zone with predictive accuracy 81 % (P < 0.001). Shorter overall survival was significant associated with higher RSI-cellularity index (hazard ratio (HR) 3.6, 95 % confidence interval (CI) 1.3-9.5, P = 0.002) with synchronal decrease in MD (HR 0.31, 95 %CI 0.1-0.8, P = 0.008) in the contrast-enhanced tumor core. This association was also consistent for RSI-cellularity index value measured in the peri-enhancing zone (HR 3.6, 95 % CI 1.0-12.3, P = 0.041). No statistically significant differences were noted between RSI-cellularity index, FA, nor MD and MGMT promoter methylation. CONCLUSION RSI-cellularity index may be used as prognostic biomarker to improve risk stratification in patients with glioblastoma.
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Affiliation(s)
- Anna Latysheva
- Section of Neuroradiology, Department of Radiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Oliver Marcel Geier
- Department of Diagnostic Physics, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Tuva R Hope
- Department of Diagnostic Physics, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Marta Brunetti
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Einar Osland Vik-Mo
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Kyrre E Emblem
- Department of Diagnostic Physics, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Andrés Server
- Section of Neuroradiology, Department of Radiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway
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Predicting Survival in Glioblastoma Patients Using Diffusion MR Imaging Metrics-A Systematic Review. Cancers (Basel) 2020; 12:cancers12102858. [PMID: 33020420 PMCID: PMC7600641 DOI: 10.3390/cancers12102858] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022] Open
Abstract
Simple Summary An accurate survival analysis is crucial for disease management in glioblastoma (GBM) patients. Due to the ability of the diffusion MRI techniques of providing a quantitative assessment of GBM tumours, an ever-growing number of studies aimed at investigating the role of diffusion MRI metrics in survival prediction of GBM patients. Since the role of diffusion MRI in prediction and evaluation of survival outcomes has not been fully addressed and results are often controversial or unsatisfactory, we performed this systematic review in order to collect, summarize and evaluate all studies evaluating the role of diffusion MRI metrics in predicting survival in GBM patients. We found that quantitative diffusion MRI metrics provide useful information for predicting survival outcomes in GBM patients, mainly in combination with other clinical and multimodality imaging parameters. Abstract Despite advances in surgical and medical treatment of glioblastoma (GBM), the medium survival is about 15 months and varies significantly, with occasional longer survivors and individuals whose tumours show a significant response to therapy with respect to others. Diffusion MRI can provide a quantitative assessment of the intratumoral heterogeneity of GBM infiltration, which is of clinical significance for targeted surgery and therapy, and aimed at improving GBM patient survival. So, the aim of this systematic review is to assess the role of diffusion MRI metrics in predicting survival of patients with GBM. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature search was performed to identify original articles since 2010 that evaluated the association of diffusion MRI metrics with overall survival (OS) and progression-free survival (PFS). The quality of the included studies was evaluated using the QUIPS tool. A total of 52 articles were selected. The most examined metrics were associated with the standard Diffusion Weighted Imaging (DWI) (34 studies) and Diffusion Tensor Imaging (DTI) models (17 studies). Our findings showed that quantitative diffusion MRI metrics provide useful information for predicting survival outcomes in GBM patients, mainly in combination with other clinical and multimodality imaging parameters.
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Zhou X, Niu X, Mao Q, Liu Y. Clinical Significance of Various Classification Standards of Age Groups in Predicting Survival of Patients with Glioblastoma. Med Sci Monit 2020; 26:e920627. [PMID: 32471970 PMCID: PMC7282532 DOI: 10.12659/msm.920627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background The present study aimed to assess the association of various age groups with survival in patients with glioblastoma. Material/Methods The Surveillance, Epidemiology, and End Results (SEER) database was used to extracted data on new diagnoses of glioblastoma between 2005 and 2015. Four age models were constructed according to the age at diagnosis. Results A total of 28 734 patients with glioblastoma (16 823 men and 11 911 women) were enrolled in the study. In multivariate analysis, variables including sex, race, tumor, and clinical information were identified as confounding factors to adjust 4 age models. In model 1, ages 39–58, 59–78, and 79+ years were risk factors of survival compared with age 0–18 years. In model 2, ages 18–65, 66–79, and 80+ years were prognostic factors of shorter survival compared with ages 0–17 years. In model 3, ages 45–59, 60–74, and 75+ years were associated with poor prognosis, while ages 18–44 years was associated with favorable clinical outcomes compared with ages 0–17 years. In model 4, ages 18–53, 54–64, and 65+ years were associated with poor prognosis. Conclusions The differences in prognoses in different age groups of glioblastoma patients suggest that clinicians should incorporate age into routine clinical assessments and develop appropriate treatment strategies.
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Affiliation(s)
- Xingwang Zhou
- Department of Neurosurgery, West China Hospital, Chengdu, Sichuan, China (mainland)
| | - Xiaodong Niu
- Department of Neurosurgery, West China Hospital, Chengdu, Sichuan, China (mainland)
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, Chengdu, Sichuan, China (mainland)
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital, Chengdu, Sichuan, China (mainland)
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