期刊
AMERICAN JOURNAL OF NEURORADIOLOGY
卷 43, 期 1, 页码 40-47出版社
AMER SOC NEURORADIOLOGY
DOI: 10.3174/ajnr.A7351
关键词
-
资金
- Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology [NRF-2020R1A2B5B01001707, NRF2020R1A2C4001748, 2020IP0097]
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
The study developed a physiologic MR imaging-based spatial habitat analysis to identify regions associated with treatment resistance in primary central nervous system lymphoma. The presence of a hypovascular cellular tumor habitat was significantly associated with short time to progression. A predictive model incorporating the habitat score and other imaging parameters showed good accuracy for predicting time to progression.
BACKGROUND AND PURPOSE: The microenvironment of lymphomas is known to be highly variable and closely associated with treatment resistance and survival. We tried to develop a physiologic MR imaging?based spatial habitat analysis to identify regions associated with treatment resistance to facilitate the prediction of tumor response after initial chemotherapy in patients with primary central nervous system lymphoma. MATERIALS AND METHODS: Eighty-one patients with pathologically confirmed primary central nervous system lymphoma were enrolled. Pretreatment physiologic MR imaging was performed, and K-means clustering was used to separate voxels into 3 spatial habitats according to ADC and CBV values. Associations of spatial habitats and clinical and conventional imaging predictors with time to progression were analyzed using Cox proportional hazards modeling. The performance of statistically significant predictors for time to progression was assessed using the concordance probability index. RESULTS: The 3 spatial habitats of hypervascular cellular tumor, hypovascular cellular tumor, and hypovascular hypocellular tumor were identified. A large hypovascular cellular habitat was most significantly associated with short time to progression (hazard ratio, 2.83; P?=?.?017). The presence of an atypical finding (hazard ratio, 4.41; P?=?.?016), high performance score (hazard ratio, 5.82; P?=?.?04), and high serum lactate dehydrogenase level (hazard ratio, 1.01; P?=?.013) was significantly associated with time to progression. A predictive model constructed using the habitat score and other imaging parameters showed a concordance probability index for prediction of time to progression of 0.70 (95% CI, 0.54?0.87). CONCLUSIONS: A hypovascular cellular tumor habitat is associated with treatment resistance in primary central nervous system lymphoma, and its assessment may refine prechemotherapy imaging?based response prediction for patients with primary central nervous system lymphoma.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据