Erschienen in:
15.10.2018 | Head and Neck
Morphological MRI-based features provide pretreatment survival prediction in glioblastoma
verfasst von:
Julián Pérez-Beteta, David Molina-García, Alicia Martínez-González, Araceli Henares-Molina, Mariano Amo-Salas, Belén Luque, Elena Arregui, Manuel Calvo, José M. Borrás, Juan Martino, Carlos Velásquez, Bárbara Meléndez-Asensio, Ángel Rodríguez de Lope, Raquel Moreno, Juan A. Barcia, Beatriz Asenjo, Manuel Benavides, Ismael Herruzo, Pedro C. Lara, Raquel Cabrera, David Albillo, Miguel Navarro, Luis A. Pérez-Romasanta, Antonio Revert, Estanislao Arana, Víctor M. Pérez-García
Erschienen in:
European Radiology
|
Ausgabe 4/2019
Einloggen, um Zugang zu erhalten
Abstract
Objectives
We wished to determine whether tumor morphology descriptors obtained from pretreatment magnetic resonance images and clinical variables could predict survival for glioblastoma patients.
Methods
A cohort of 404 glioblastoma patients (311 discoveries and 93 validations) was used in the study. Pretreatment volumetric postcontrast T1-weighted magnetic resonance images were segmented to obtain the relevant morphological measures. Kaplan-Meier, Cox proportional hazards, correlations, and Harrell’s concordance indexes (c-indexes) were used for the statistical analysis.
Results
A linear prognostic model based on the outstanding variables (age, contrast-enhanced (CE) rim width, and surface regularity) identified a group of patients with significantly better survival (p < 0.001, HR = 2.57) with high accuracy (discovery c-index = 0.74; validation c-index = 0.77). A similar model applied to totally resected patients was also able to predict survival (p < 0.001, HR = 3.43) with high predictive value (discovery c-index = 0.81; validation c-index = 0.92). Biopsied patients with better survival were well identified (p < 0.001, HR = 7.25) by a model including age and CE volume (c-index = 0.87).
Conclusions
Simple linear models based on small sets of meaningful MRI-based pretreatment morphological features and age predicted survival of glioblastoma patients to a high degree of accuracy. The partition of the population using the extent of resection improved the prognostic value of those measures.
Key Points
• A combination of two MRI-based morphological features (CE rim width and surface regularity) and patients’ age outperformed previous prognosis scores for glioblastoma.
• Prognosis models for homogeneous surgical procedure groups led to even more accurate survival prediction based on Kaplan-Meier analysis and concordance indexes.