Quantification of Nonenhancing Tumor Burden in Gliomas Using Effective T2 Maps Derived from Dual-Echo Turbo Spin-Echo MRI.
Quantification of Nonenhancing Tumor Burden in Gliomas Using Effective T2 Maps Derived from Dual-Echo Turbo Spin-Echo MRI.
复制标题
DOI：
10.1158/1078-0432.ccr-14-2862
复制
发表时间：
2015-10-01
期刊：
影响因子：
--
通讯作者：
Cloughesy TF
中科院分区：
文献类型：
--
作者：
Ellingson BM;Lai A;Nguyen HN;Nghiemphu PL;Pope WB;Cloughesy TF
非增强性肿瘤（NET）负荷的评价是脑肿瘤缓解评估的一个重要但具有挑战性的部分。目前的研究重点是使用双回波快速自旋回波MRI作为快速估计组织T2的方法，可用于客观定义NET负荷。进行了一系列实验，以确定使用T2图定义NET负荷。首先，在T2的变化，确定使用ACR水幻影在16台扫描仪评价超过3年。接下来，检查T2图用于从其他组织中描绘NET的灵敏度和特异性。然后，使用T2定义的NET预测接受放疗、同步放疗和化疗或复发时贝伐单抗治疗的胶质母细胞瘤患者的不同亚组的生存率。ACR体模中T2的变异性为3- 5%。在训练数据中，ROC分析显示125 ms < T2 < 250ms could delineate NET with a sensitivity >90%，特异性> 65%。使用该标准，单独完成放疗或同时完成放疗和化疗后的NET负荷被证明是生存期的预测指标（考克斯，P<0.05），复发性胶质母细胞瘤贝伐单抗治疗前后NET体积的变化也是生存期的预测指标（P<0.05）。使用双回波数据的T2标测图是可行的、稳定的，可用于客观定义NET负荷，以用于脑肿瘤表征、预后和缓解评估。应在随机临床试验中验证使用有效T2图定义NET负荷。
Evaluation of nonenhancing tumor (NET) burden is an important, yet challenging part of brain tumor response assessment. The current study focuses on using dual echo turbo spin echo MRI as a means of quickly estimating tissue T2, which can be used to objectively define NET burden. A series of experiments were performed to establish the use of T2 maps for defining NET burden. First, variation in T2 was determined using ACR water phantoms in 16 scanners evaluated over 3 years. Next, sensitivity and specificity of T2 maps for delineating NET from other tissues was examined. Then, T2-defined NET was used to predict survival in separate subsets of glioblastoma patients treated with radiation therapy, concurrent radiation and chemotherapy, or bevacizumab at recurrence. Variability in T2 in the ACR phantom was 3-5%. In training data, ROC analysis suggested that 125ms < T2 < 250ms could delineate NET with a sensitivity >90% and specificity >65%. Using this criterion, NET burden after completion of radiation therapy alone, or concurrent radiation therapy and chemotherapy, was shown to be predictive of survival (Cox, P<0.05), and the change in NET volume before and after bevacizumab therapy in recurrent glioblastoma was also a predictive of survival (P<0.05). T2 maps using dual echo data are feasible, stable, and can be used to objectively define NET burden for use in brain tumor characterization, prognosis, and response assessment. The use of effective T2 maps for defining NET burden should be validated in a randomized clinical trial.