Baseline Volumetric T2 Relaxation Time Histogram Analysis: Can It Be Used to Predict the Response to Intravenous Methylprednisolone Therapy in Patients With Thyroid- Associated Ophthalmopathy?
Baseline Volumetric T2 Relaxation Time Histogram Analysis: Can It Be Used to Predict the Response to Intravenous Methylprednisolone Therapy in Patients With Thyroid- Associated Ophthalmopathy?
复制标题
基线体积 T2 弛豫时间直方图分析：能否用于预测甲状腺相关眼病患者对静脉注射甲泼尼龙治疗的反应？
DOI：
10.3389/fendo.2021.6145
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发表时间：
2021
影响因子：
5.2
通讯作者：
Jing Zhang
中科院分区：
文献类型：
--
作者：
Ping Liu;Ban Luo;Lang Chen;Qiu-Xia Wang;Gang Yuan;Gui-hua Jiang;Jing Zhang
目的：预测静脉注射甲基强的松龙脉冲治疗（ivMP）的疗效对甲状腺相关性眼病（TAO）至关重要。图像直方图可能为治疗效果预测提供敏感的成像生物标志物。本研究旨在探讨治疗前眼外肌（EOMs）的多参数T2松弛时间（T2RT）直方图特征是否可用于预测治疗反应。材料和方法：本研究回顾性纳入45例经标准ivMP治疗并在治疗前行眶核磁共振检查的活动性和中重度TAO患者。根据临床评价将患者分为反应组（n = 24、48眼）和无反应组（n = 21、42眼）。分析比较患者的基线临床特征和EOMs的直方图衍生的T2RT参数。采用Logistic回归模型确定独立预测因子，并建立直方图特征nomogram进行个性化预测。结果：反应组在第5、10个百分位数的数值较低（P = 88.1）[比值比(OR) = 12.078；95%置信区间(CI) = 3.98 ~ 36.655, p 0.31 (OR = 3.935; 95% CI = 2.28 ~ 6.788, p 3.41 （OR = 4.375; 95% CI = 2.604 ~ 7.351, p < 0.001）为良好反应的独立预测因子。3个独立预测因子的nomogram积分显示出最优的预测效率，C-index为0.792。结论：治疗前EOMs的T2RT体积直方图特征可以预测TAO患者对ivMP的反应。基于直方图特征的nomogram有助于选择从ivMP中获益最大的患者。
Objective: Prediction of therapy response to intravenous methylprednisolone pulses (ivMP) is crucial for thyroid-associated ophthalmopathy (TAO). Image histograms may offer sensitive imaging biomarkers for therapy effect prediction. This study aimed to investigate whether pretherapeutic, multiparametric T2 relaxation time(T2RT) histogram features of extraocular muscles (EOMs) can be used to predict therapy response..Materials and Methods: Forty-five active and moderate-severe TAO patients, who were treated with standard ivMP and underwent orbital MRI before therapy, were retrospectively included in this study. The patients were divided into responsive (n = 24, 48 eyes) and unresponsive group(n = 21, 42 eyes) according to clinical evaluation. Baseline clinical features of patients and histogram-derived T2RT parameters of the EOMs were analyzed and compared. Logistic regression model was conducted to determine independent predictors, and a histogram features nomogram was formulated for personalized prediction..Results: Responsive group displayed lower values for 5th, 1 0thpercentiles (P 88.1 [odds ratio (OR) = 12.078; 95% confidence interval (CI) = 3.98–36.655, p 0.31 (OR = 3.935; 95% CI = 2.28–6.788, p 3.41 (OR = 4.375; 95% CI = 2.604–7.351, p < 0.001) were independent predictors for favorable response. The nomogram integration of three independent predictors demonstrated optimal predictive efficiency, with a C-index of 0.792..Conclusions: Pre-treatment volumetric T2RT histogram features of EOMs could function to predict the response to ivMP in patients with TAO. The nomogram based on histogram features facilitates the selection of patients who will derive maximal benefit from ivMP.