Malignant supratentorial astrocytoma treated with postoperative radiation therapy: Prognostic value of pretreatment quantitative diffusion-weighted MR imaging
Malignant supratentorial astrocytoma treated with postoperative radiation therapy: Prognostic value of pretreatment quantitative diffusion-weighted MR imaging
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DOI：
10.1148/radiol.2432060450
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发表时间：
2007-05-01
期刊：
影响因子：
19.7
通讯作者：
Yamashita, Yasuyuki
中科院分区：
文献类型：
--
作者：
Murakami, Ryuji;Sugahara, Takeshi;Yamashita, Yasuyuki
目的：回顾性评估是否最小表观扩散系数（ADC）的肿瘤治疗前的磁共振（MR）图像上看到的是恶性幕上星形细胞tumor.Materials and Methods患者的预后价值：该研究是由机构审查委员会批准的，患者知情同意的要求被免除。1996年6月至2003年11月，79例（44例男性，35例女性;年龄范围，16-76岁）恶性幕上星形细胞瘤患者接受了治疗前MR成像。在生存因素分析中评估患者年龄、症状持续时间、神经功能、精神状态、Karnofsky行为量表（KPS）评分、手术范围、组织病理学诊断、肿瘤成分增强和最小ADC。放射治疗肿瘤组递归分割分析（RTOG-RPA）标准用于验证最小ADC的预后价值。Kaplan-Meier生存曲线、log-rank检验和多因素考克斯比例风险模型用于评估预后因素。多形性胶质母细胞瘤的最小ADC值明显低于间变性星形细胞瘤（P <0.001）。最小ADC值较低（1.0 × 10（-3）mm（2）/sec）的患者2年生存率分别为14%（6/42例）和84%（31/37例）（P <0.001）。最小ADC值是最重要的预后因素（危险比= 10.459; 95%可信区间：5.113，21.396），可用于将患者分为不同的预后组，每个RTOG-RPA classes.Conclusion：MRI预处理时的最小ADC值是预测恶性幕上星形细胞瘤患者生存的一个有用的临床预后生物标志物。(c)RSNA，2007年。
Purpose: To retrospectively evaluate whether the minimum apparent diffusion coefficient (ADC) of the tumor seen on pretreatment magnetic resonance (MR) images is of prognostic value in patients with malignant supratentorial astrocytoma.Materials and Methods: The study was approved by the institutional review board; the requirement for informed patient consent was waived. Between June 1996 and November 2003, 79 patients (44 male, 35 female; age range, 16-76 years) with malignant supratentorial astrocytoma underwent pretreatment MR imaging. Patient age, symptom duration, neurologic function, mental status, Karnofsky performance scale (KPS) score, extent of surgery, histopathologic diagnosis, tumor component enhancement, and minimum ADC were assessed at factor analysis of survival. Radiation Therapy Oncology Group-recursive partitioning analysis (RTOG-RPA) criteria were used to validate the prognostic value of the minimum ADC. Kaplan-Meier survival curves, the log-rank test, and the multivariate Cox proportional hazards model were used to evaluate the prognostic factors.Results: Twenty-nine patients had anaplastic astrocytoma, and 50 had glioblastoma multiforme. The minimum ADC was significantly lower in patients with glioblastoma multiforme than in those with anaplastic astrocytoma (P < .001). The two-year survival rates associated with low ( 1.0 x 10(-3) mm(2)/sec) minimum ADCs were 14% ( six of 42 patients) and 84% ( 31 of 37 patients), respectively (P < .001). The minimum ADC was the most important prognostic factor (hazard ratio = 10.459; 95% confidence interval: 5.113, 21.396) and could be used to assign patients to different prognostic groups in each RTOG- RPA class.Conclusion: The minimum ADC at pretreatment MR imaging is a useful clinical prognostic biomarker for survival in patients with malignant supratentorial astrocytoma. (c) RSNA, 2007.