Can Tumor Location on Pre-treatment MRI Predict Likelihood of Pseudo-Progression vs. Tumor Recurrence in Glioblastoma?-A Feasibility Study.
Can Tumor Location on Pre-treatment MRI Predict Likelihood of Pseudo-Progression vs. Tumor Recurrence in Glioblastoma?-A Feasibility Study.
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DOI：
10.3389/fncom.2020.563439
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发表时间：
2020
影响因子：
3.2
通讯作者：
Tiwari P
中科院分区：
文献类型：
--
作者：
Ismail M;Hill V;Statsevych V;Mason E;Correa R;Prasanna P;Singh G;Bera K;Thawani R;Ahluwalia M;Madabhushi A;Tiwari P
胶质母细胞瘤(GBM)治疗中的一个重大挑战是在常规治疗后的常规影像上识别假性进展(PSP)，这是一种由肿瘤复发引起的良性辐射诱导效应。以前的研究已经将肿瘤叶的存在和偏侧性与基底膜的预后联系起来，表明基底膜的疾病病因和进展可能受到肿瘤位置的影响。因此，在这项可行性研究中，我们试图调查以下问题：治疗初期MRI上的肿瘤定位能否提供有关患者发生假性进展与肿瘤复发的可能性的早期线索？本研究对74例治疗前有PSP(33例)和肿瘤复发(41例)的胶质母细胞瘤MRI扫描进行了分析。首先，由专家对Gd-T1w增强病变和T2w/FLAIR周围高信号进行分割，并登记到脑图谱中。使用这两种表型的患者，我们通过量化病变增强和病变周围高信号的发生频率，通过平均整个人群的体素强度来构建两个图谱。然后进行差异性分析以计算各图谱的体素显着差异(p值和0.05)。统计上有意义的集群最终被映射到结构图谱，以提供其位置的解剖学定位。我们的结果表明，肿瘤复发患者的初始肿瘤突出在顶叶，而PSP患者的初始肿瘤表现为额叶、颞叶、岛叶和壳核的多灶性分布。这些初步结果表明，将治疗前的病变偏侧到大脑的某些解剖区域，可以提供早期线索，评估MRI扫描上肿瘤复发发生假性进展的可能性。
A significant challenge in Glioblastoma (GBM) management is identifying pseudo-progression (PsP), a benign radiation-induced effect, from tumor recurrence, on routine imaging following conventional treatment. Previous studies have linked tumor lobar presence and laterality to GBM outcomes, suggesting that disease etiology and progression in GBM may be impacted by tumor location. Hence, in this feasibility study, we seek to investigate the following question: Can tumor location on treatment-naïve MRI provide early cues regarding likelihood of a patient developing pseudo-progression vs. tumor recurrence? In this study, 74 pre-treatment Glioblastoma MRI scans with PsP (33) and tumor recurrence (41) were analyzed. First, enhancing lesion on Gd-T1w MRI and peri-lesional hyperintensities on T2w/FLAIR were segmented by experts and then registered to a brain atlas. Using patients from the two phenotypes, we construct two atlases by quantifying frequency of occurrence of enhancing lesion and peri-lesion hyperintensities, by averaging voxel intensities across the population. Analysis of differential involvement was then performed to compute voxel-wise significant differences (p-value < 0.05) across the atlases. Statistically significant clusters were finally mapped to a structural atlas to provide anatomic localization of their location. Our results demonstrate that patients with tumor recurrence showed prominence of their initial tumor in the parietal lobe, while patients with PsP showed a multi-focal distribution of the initial tumor in the frontal and temporal lobes, insula, and putamen. These preliminary results suggest that lateralization of pre-treatment lesions toward certain anatomical areas of the brain may allow to provide early cues regarding assessing likelihood of occurrence of pseudo-progression from tumor recurrence on MRI scans.
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DOI：
10.3174/ajnr.a4631
发表时间：
2016-04
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
Liu TT;Achrol AS;Mitchell LA;Du WA;Loya JJ;Rodriguez SA;Feroze A;Westbroek EM;Yeom KW;Stuart JM;Chang SD;Harsh GR 4th;Rubin DL
通讯作者：
Rubin DL
影响因子：
5.6
作者：
Parvez K;Parvez A;Zadeh G
通讯作者：
Zadeh G
影响因子：
3.7
作者：
Eloyan A;Shou H;Shinohara RT;Sweeney EM;Nebel MB;Cuzzocreo JL;Calabresi PA;Reich DS;Lindquist MA;Crainiceanu CM
通讯作者：
Crainiceanu CM
影响因子：
6.2
作者：
Duffau, H;Capelle, L
通讯作者：
Capelle, L
影响因子：
5.7
作者：
Drabycz, Sylvia;Roldan, Gloria;Mitchell, J. Ross
通讯作者：
Mitchell, J. Ross