MRI放射组学特征预测胶质母细胞瘤患者预后  

Prediction of prognosis in patients with glioblastoma using radiomics features based on MRI

作　　者：李京龙[1] 王占秋[1] 顾长聪 赵月梅 陈涛 李文菲[1] LI Jinglong;WANG Zhanqiu;GU Changcong;ZHAO Yuemei;CHEN Tao;LI Wenfei(Department of Imaging,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Nuclear Medicine,Xiangyang Central Hospital,Xiangyang 441000,Hubei Province,China)

机构地区：[1]秦皇岛市第一医院影像科,河北秦皇岛066000 [2]襄阳市中心医院核医学科,湖北襄阳441000

出　　处：《肿瘤影像学》2022年第6期596-601,共6页Oncoradiology

基　　金：秦皇岛市科技计划项目(201805A078);河北省伦琴影像科研项目(HB-201906-018)。

摘　　要：目的:基于磁共振成像(magnetic resonance imaging,MRI)放射组学特征预测胶质母细胞瘤患者的预后的临床价值。方法:将130例术前接受MRI的胶质母细胞瘤患者纳入研究。从瘤周水肿区域、肿瘤的增强区域、坏死核心区域中分别提取放射组学特征,利用最小绝对收缩与选择算子(least absolute shrinkage and selection operator,LASSO)建立放射组学特征模型,以10折交叉验证方法对模型进行检验。根据组学评分合适的阈值将患者分为高风险组和低风险组。亚组分析观察替莫唑胺辅助放疗是否有助于延长高风险患者的生存期。结果:选择了16个与胶质母细胞瘤患者预后显著相关的组学特征来构建放射组学模型,其中4个来自瘤周水肿区域,9个来自肿瘤的增强区域,其余3个来自坏死核心区域。多因素Cox回归分析显示放射组学评分是胶质母细胞瘤患者的独立危险因素。根据放射组学评分的阈值,61例(46.9%)患者被分为高风险组,另外69例(53.1%)患者被分为低风险组,两组的生存期及无进展生存期差异有统计学意义。亚组分析结果显示高风险组中同步放化疗患者生存期(14.2个月)明显长于单纯放疗组(7.1个月,P=0.00016)。结论:基于MRI放射组学特征不仅与预后密切相关,并且能有效地对胶质母细胞瘤患者进行风险分层。高风险患者可以从替莫唑胺辅助同步放疗方案中获益。Objective:To explore the clinical value of features of radiomics model based on magnetic resonance imaging(MRI)in preoperative predicting the prognosis of patients with glioblastoma.Methods:A total of 130 glioblastoma patients who underwent preoperative MRI were enrolled in the study.Radiomics features were extracted from the edema area,the core area and the necrotic core area of the tumor respectively.Least absolute shrinkage and selection operator(LASSO)regression algorithm was implemented to establish the radiomics characteristic model,which was tested by ten-fold cross validation method.Patients were divided into high and low-risk groups according to the optimum threshold of radiomics score.Subgroup’s analysis was performed to observe whether temozolomide adjuvant radiotherapy can prolong the survival of high-risk patients.Results:A total of 16 features were selected to construct the radiomic model significantly related to overall survival for patients with glioblastoma,including 4 from the edema area,9 from the core area,3 from the necrotic core of glioblastoma.Multivariate Cox regression analysis showed that radiomics score was an independent risk factor for patients with glioblastoma.According to the threshold of radiomics score,patients was categorized as low risk(n=69,53.1%)and high risk(n=61,46.9%).There were significant differences in survival and progression free survival between the two groups.Subgroup analysis showed that high-risk patient’s the OS(14.2 months)with temozolomide concurrent chemoradiotherapy was significantly longer than that in the radiotherapy group(7.1 months,P=0.00016).Conclusion:The radiomics features obtained from MRI-based radiomic model are associated with the prognostic and can stratify patients into high-risk and low-risk groups successfully.High risk patients can benefit from temozolomide concurrent radiotherapy.

关 键 词：胶质母细胞瘤 磁共振成像 放射组学 放疗 预后 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]