Spectroscopic and perfusion magnetic resonance imaging predictors of progression in pediatric brain tumors
Spectroscopic and perfusion magnetic resonance imaging predictors of progression in pediatric brain tumors
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DOI：
10.1002/cncr.20096
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发表时间：
2004-03-15
期刊：
影响因子：
6.2
通讯作者：
Black, PM
中科院分区：
文献类型：
--
作者：
Tzika, AA;Astrakas, LG;Black, PM
背景。体内生物标志物预测脑肿瘤的进展在临床实践中具有重要价值。因此，作者验证了通过磁共振（MR）光谱成像和/或相对肿瘤血容量（rTBV）测定胆碱比值的变化可以区分临床稳定型和进展型儿童脑肿瘤的假设。对27例神经胶质性脑肿瘤患儿在1.5-Tesla MR系统治疗期间进行了磁共振光谱成像检查。27例患者中有11例测量了归一化rTBV值。根据临床和影像学标准将各项检查评定为稳定或进展。渐进式检查患者的正常化胆碱（Cho）变化百分比明显大于稳定检查患者（P = 0.03）。Cho/ n -乙酰天冬氨酸（Cho/NAA）在进展性患者（n = 18例）中的变化百分比明显高于稳定性患者（n = 32例，P < 0.001；敏感性0.89；特异性0.88），经logistic回归（似然比检验，33.4;P < 0.001）确定为肿瘤进展最重要的预后指标。对于Cho/NAA变化至少20%的患者，肿瘤进展的几率约为55倍。rTBV可区分进展性肿瘤和稳定性肿瘤（P = 0.03）， Cho/NAA和rTBV值可相互作用预测进展性临床结局的概率。在rTBV辅助下，质子磁共振成像Cho/NAA的百分比变化对预测儿童脑肿瘤的进展是有用的。(C) 2004年美国癌症协会。
BACKGROUND. in vivo biomarkers to predict progression of brain tumors are of great value in clinical practice. Therefore, the authors tested the hypothesis that changes in choline ratios by magnetic resonance (MR) spectroscopic imaging and/or relative tumor blood volume (rTBV) can differentiate clinically stable from progressive pediatric brain tumors.METHODS. MR spectroscopic imaging examinations were performed on 27 children with neuroglial brain tumors during therapy on a 1.5-Tesla MR system. Normalized rTBV values were measured in 11 of 27 patients. Each examination was rated as stable or progressive by clinical and imaging criteria.RESULTS. The percent change in normalized choline (Cho) was significantly greater in patients who had progressive examinations compared with patients who had stable examinations (P = 0.03). The percent change in Cho/N-acetylaspartate (Cho/NAA) was significantly higher in patients who had progressive outcomes (n = 18 patients) compared with patients who had stable outcomes (n = 32 patients; P < 0.001; sensitivity, 0.89; specificity, 0.88) and was identified as the most important prognostic indicator of tumor progression by logistic regression (likelihood ratio test, 33.4; P < 0.001). The odds of tumor progression were approximately 55 times greater for patients who showed at least a 20% change in Cho/NAA. rTBV distinguished between progressing and stable tumors (P = 0.03), and Cho/NAA and rTBV values showed interaction to predict the probability of a progressing clinical outcome.CONCLUSIONS. The percent change in Cho/NAA by proton MR spectroscopic imaging, assisted by rTBV, was useful in predicting tumor progression in children with brain tumors. (C) 2004 American Cancer Society.