Histogram Analysis of Intravoxel Incoherent Motion for Differentiating Recurrent Tumor from Treatment Effect in Patients with Glioblastoma: Initial Clinical Experience
Histogram Analysis of Intravoxel Incoherent Motion for Differentiating Recurrent Tumor from Treatment Effect in Patients with Glioblastoma: Initial Clinical Experience
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DOI：
10.3174/ajnr.a3719
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发表时间：
2014-03-01
影响因子：
3.5
通讯作者：
Kim, S. J.
中科院分区：
文献类型：
--
作者：
Kim, H. S.;Suh, C. H.;Kim, S. J.
背景和目的：体素内非相干运动可以同时测量扩散和灌注特征。我们的目的是确定体素内非相干运动的血流灌注和扩散参数是否可以作为区分胶质母细胞瘤患者复发和治疗效果的成像生物标志物。材料和方法：对51例经病理证实的复发肿瘤(n=31)或治疗有效(n=20)的患者进行体素内非相干运动磁共振成像。计算灌注和归一化CBV的第90个百分位数和弥散和ADC的第10个百分位数的直方图分界值，并与最终的病理结果相关联。结果：肿瘤复发组平均90%血流灌注百分位数(0.084+/-0.020)显著高于有效组(0.040+/-0.010)(P<；.001)。与归一化CBV的第90个百分位数相比，血流灌注的第90个百分位数提供的重叠区内的患者数量较少，在重叠区域中可能发生错误分类。复发肿瘤组扩散百分位数平均值显著低于有效组(P=.006)。受试者操作特征曲线分析显示，第90百分位数的血流灌注值是预测肿瘤分化程度的重要指标，其敏感性为87.1%，特异性为95.0%。脑血流灌注的第90百分位数与正常化的脑血流量呈显著正相关(r=0.674；P<0.01)。结论：体素内非相干运动参数的直方图分析可作为鉴别胶质母细胞瘤患者复发肿瘤与治疗效果的无创性成像生物标志物。
BACKGROUND AND PURPOSE:Intravoxel incoherent motion can simultaneously measure diffusion and perfusion characteristics. Our aim was to determine whether the perfusion and diffusion parameters derived from intravoxel incoherent motion could act as imaging biomarkers for distinguishing recurrent tumor from treatment effect in patients with glioblastoma.MATERIALS AND METHODS:Fifty-one patients with pathologically confirmed recurrent tumor (n = 31) or treatment effect (n = 20) were assessed by means of intravoxel incoherent motion MR imaging. The histogram cutoffs of the 90th percentiles for perfusion and normalized CBV and the 10th percentiles for diffusion and ADC were calculated and correlated with the final pathology results. A leave-one-out cross-validation was used to evaluate the diagnostic performance of our classifiers.RESULTS:The mean 90th percentile for perfusion was significantly higher in the recurrent tumor group (0.084 +/- 0.020) than in the treatment effect group (0.040 +/- 0.010) (P < .001). The 90th percentile for perfusion provided a smaller number of patients within an overlap zone in which misclassifications can occur, compared with the 90th percentile for normalized CBV. The mean 10th percentile for diffusion was significantly lower in the recurrent tumor group than in the treatment effect group (P = .006). Receiver operating characteristic curve analyses showed the 90th percentile for perfusion to be a significant predictor for differentiation, with a sensitivity of 87.1% and a specificity of 95.0%. There was a significant positive correlation between the 90th percentiles for perfusion and normalized CBV (r = 0.674; P < .001).CONCLUSIONS:A histogram analysis of intravoxel incoherent motion parameters can be used as a noninvasive imaging biomarker for differentiating recurrent tumor from treatment effect in patients with glioblastoma.