Identification of MRI and 1H MRSI parameters that may predict survival for patients with malignant gliomas
Identification of MRI and 1H MRSI parameters that may predict survival for patients with malignant gliomas
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DOI：
10.1002/nbm.858
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发表时间：
2004-02-01
影响因子：
2.9
通讯作者：
Nelson, SJ
中科院分区：
文献类型：
--
作者：
Li, XJ;Jin, H;Nelson, SJ
虽然磁共振成像（MRI）和磁共振光谱成像（MRSI）已应用于脑肿瘤的诊断和治疗计划，但其预后意义尚未确定。本研究的目的是确定恶性胶质瘤患者的治疗前MRI和MRSI参数，这些参数可能有助于预测患者的生存。对两组新诊断的恶性胶质瘤患者进行MRI和三维质子（H-1）磁共振成像检查。手术前研究了39例患者（22例3级和17例多形性胶质母细胞瘤，GBM），手术后但放疗和化疗前研究了33例GBM患者。根据光谱估计了胆碱（Cho）、肌酸（Cr）、n -乙酰天冬氨酸（NAA）和乳酸/脂质（LL）的信号强度。对年龄、组织学分级、MRI和MRSI变量等参数采用递归划分方法生成生存树。将患者分为高危和低危两类，绘制相应的Kaplan-Meier曲线进行组间比较。通过递归划分选择的预测不良预后的参数为年龄较大、对比度增强较大、较高的Cho-to-Cr、较高的Cho-to-NAA、较高的LL和较低的Cr-to-NAA异常。术前和术后生存树数据的亚组患者的生存功能有显著差异。本研究的结果表明，治疗前MRI和三维H-1-MRSI提供了预测恶性胶质瘤患者预后的信息，并引起了人们对未来使用这些技术研究中应该前瞻性检查的变量的关注。版权所有：John Wiley Sons， Ltd. 2004
Although MR imaging (MRI) and MR spectroscopic imaging (MRSI) have been applied in the diagnosis and treatment planning for brain tumors, their prognostic significance has not yet been determined. The goal of this study was to identify pre-treatment MRI and MRSI parameters for patients with malignant glioma that may be useful in predicting survival. Two populations of patients with newly-diagnosed malignant glioma were examined with MRI and three-dimensional proton (H-1) MRSI. Thirty-nine patients (22 grade 3 and 17 glioblastoma multiforme, GBM) were studied prior to surgery, and 33 GBM patients were studied after surgery but prior to treatment with radiation and chemotherapy. Signal intensities of choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), and lactate/lipid (LL) were estimated from the spectra. Recursive partitioning methods were applied to parameters that included age, histological grade, MRI and MRSI variables to generate survival trees. Patients were grouped into high and low risk categories and the corresponding Kaplan-Meier curves were plotted for comparison between groups. The parameters that were selected by recursive partitioning as being predictive of poor outcome were older age, larger contrast enhancement, higher Cho-to-Cr, higher Cho-to-NAA, higher LL and lower Cr-to-NAA abnormalities. The survival functions were significantly different between the sub-groups of patients obtained from the survival tree for both pre-surgery and post-surgery data. The results of this study suggest that pre-treatment MRI and three-dimensional H-1-MRSI provide information that predicts outcome for patients with malignant gliomas and have drawn attention to variables that should be examined prospectively in future studies using these techniques. Copyright (C) 2004 John Wiley Sons, Ltd.