학술논문
Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles.
Document Type
Academic Journal
Author
Pons-Escoda A; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain. albert.pons@bellvitgehospital.cat.; Neuro-oncology Unit, Feixa Llarga SN, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, 08907, Barcelona, Spain. albert.pons@bellvitgehospital.cat.; Facultat de Medicina i Ciències de La Salut, Universitat de Barcelona (UB), Carrer de Casanova 143, 08036, Barcelona, Spain. albert.pons@bellvitgehospital.cat.; Diagnostic Imaging and Nuclear Medicine Research Group, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, Feixa Llarga SN, 08907, Barcelona, Spain. albert.pons@bellvitgehospital.cat.; Garcia-Ruiz A; Radiomics Group, Vall d'Hebron Institut d'Oncologia- VHIO, Carrer de Natzaret, 115-117, 08035, Barcelona, Spain.; Naval-Baudin P; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Diagnostic Imaging and Nuclear Medicine Research Group, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, Feixa Llarga SN, 08907, Barcelona, Spain.; Martinez-Zalacain I; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Diagnostic Imaging and Nuclear Medicine Research Group, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, Feixa Llarga SN, 08907, Barcelona, Spain.; Castell J; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Camins A; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Vidal N; Neuro-oncology Unit, Feixa Llarga SN, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, 08907, Barcelona, Spain.; Pathology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Bruna J; Neuro-oncology Unit, Feixa Llarga SN, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, 08907, Barcelona, Spain.; Cos M; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Perez-Lopez R; Radiomics Group, Vall d'Hebron Institut d'Oncologia- VHIO, Carrer de Natzaret, 115-117, 08035, Barcelona, Spain.; Oleaga L; Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.; Warnert E; Department of Radiology & Nuclear Medicine, Erasmus MC, Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.; Erasmus MC Cancer Institute, Erasmus MC, Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.; Smits M; Department of Radiology & Nuclear Medicine, Erasmus MC, Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.; Erasmus MC Cancer Institute, Erasmus MC, Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.; Medical Delta, Delft, The Netherlands.; Majos C; Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.; Neuro-oncology Unit, Feixa Llarga SN, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, 08907, Barcelona, Spain.; Diagnostic Imaging and Nuclear Medicine Research Group, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, Feixa Llarga SN, 08907, Barcelona, Spain.
Source
Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. This research aims to provide a comprehensive understanding of each tumor's DSC-PWI signatures, evaluate the discriminative capacity of cerebral blood volume (CBV) and percentage of signal recovery (PSR) percentile values, and explore the synergy of CBV and PSR combination for pre-surgical differentiation.
Methods: Patients diagnosed with grade 2 and 3 IDH-mutant astrocytomas and IDH-mutant 1p19q-codeleted oligodendrogliomas were retrospectively retrieved (2010-2022). 3D segmentations of each tumor were conducted, and voxel-level CBV and PSR were extracted to compute mean, minimum, maximum, and percentile values. Statistical comparisons were performed using the Mann-Whitney U test and the area under the receiver operating characteristic curve (AUC-ROC). Lastly, the five most discriminative variables were combined for classification with internal cross-validation.
Results: The study enrolled 52 patients (mean age 45-year-old, 28 men): 28 astrocytomas and 24 oligodendrogliomas. Oligodendrogliomas exhibited higher CBV and lower PSR than astrocytomas across all metrics (e.g., mean CBV = 2.05 and 1.55, PSR = 0.68 and 0.81 respectively). The highest AUC-ROCs and the smallest p values originated from CBV and PSR percentiles (e.g., PSRp70 AUC-ROC = 0.84 and p value = 0.0005, CBVp75 AUC-ROC = 0.8 and p value = 0.0006). The mean, minimum, and maximum values yielded lower results. Combining the best five variables (PSRp65, CBVp70, PSRp60, CBVp75, and PSRp40) achieved a mean AUC-ROC of 0.87 for differentiation.
Conclusions: Oligodendrogliomas exhibit higher CBV and lower PSR than astrocytomas, traits that are emphasized when considering percentiles rather than mean or extreme values. The combination of CBV and PSR percentiles results in promising classification outcomes.
Clinical Relevance Statement: The combination of histogram-derived percentile values of cerebral blood volume and percentage of signal recovery from DSC-PWI enhances the presurgical differentiation between astrocytomas and oligodendrogliomas, suggesting that incorporating these metrics into clinical practice could be beneficial.
Key Points: • The unsupervised selection of percentile values for cerebral blood volume and percentage of signal recovery enhances presurgical differentiation of astrocytomas and oligodendrogliomas. • Oligodendrogliomas exhibit higher cerebral blood volume and lower percentage of signal recovery than astrocytomas. • Cerebral blood volume and percentage of signal recovery combined provide a broader perspective on tumor vasculature and yield promising results for this preoperative classification.
(© 2024. The Author(s).)
Methods: Patients diagnosed with grade 2 and 3 IDH-mutant astrocytomas and IDH-mutant 1p19q-codeleted oligodendrogliomas were retrospectively retrieved (2010-2022). 3D segmentations of each tumor were conducted, and voxel-level CBV and PSR were extracted to compute mean, minimum, maximum, and percentile values. Statistical comparisons were performed using the Mann-Whitney U test and the area under the receiver operating characteristic curve (AUC-ROC). Lastly, the five most discriminative variables were combined for classification with internal cross-validation.
Results: The study enrolled 52 patients (mean age 45-year-old, 28 men): 28 astrocytomas and 24 oligodendrogliomas. Oligodendrogliomas exhibited higher CBV and lower PSR than astrocytomas across all metrics (e.g., mean CBV = 2.05 and 1.55, PSR = 0.68 and 0.81 respectively). The highest AUC-ROCs and the smallest p values originated from CBV and PSR percentiles (e.g., PSRp70 AUC-ROC = 0.84 and p value = 0.0005, CBVp75 AUC-ROC = 0.8 and p value = 0.0006). The mean, minimum, and maximum values yielded lower results. Combining the best five variables (PSRp65, CBVp70, PSRp60, CBVp75, and PSRp40) achieved a mean AUC-ROC of 0.87 for differentiation.
Conclusions: Oligodendrogliomas exhibit higher CBV and lower PSR than astrocytomas, traits that are emphasized when considering percentiles rather than mean or extreme values. The combination of CBV and PSR percentiles results in promising classification outcomes.
Clinical Relevance Statement: The combination of histogram-derived percentile values of cerebral blood volume and percentage of signal recovery from DSC-PWI enhances the presurgical differentiation between astrocytomas and oligodendrogliomas, suggesting that incorporating these metrics into clinical practice could be beneficial.
Key Points: • The unsupervised selection of percentile values for cerebral blood volume and percentage of signal recovery enhances presurgical differentiation of astrocytomas and oligodendrogliomas. • Oligodendrogliomas exhibit higher cerebral blood volume and lower percentage of signal recovery than astrocytomas. • Cerebral blood volume and percentage of signal recovery combined provide a broader perspective on tumor vasculature and yield promising results for this preoperative classification.
(© 2024. The Author(s).)