Predicting outcome in childhood diffuse midline gliomas using magnetic resonance imaging based texture analysis - 03/06/21
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Graphical abstract |
The filtration-histogram based MRTA of a T2 slice highlighting the largest cross-section of the tumour patient with DMG.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Childhood diffuse midline gliomas of the pons (DMG) with more homogeneous texture on diagnostic MRI is associated with worse prognosis. |
• | MRI based texture analysis (MRTA) on T2W is better at predicting the outcome of DMG than MRTA on ADC maps. |
• | Texture parameter Mean of Positive Pixels (MPP) is the most predictive marker of overall survival in childhood DMG. |
• | MRI based texture analysis (MRTA) has potential to be imaging biomarker in predicting the outcome of DMG. |
Abstract |
Background |
Diffuse midline gliomas (DMG) are aggressive brain tumours, previously known as diffuse intrinsic pontine gliomas (DIPG), with 10% overall survival (OS) at 18 months. Predicting OS will help refine treatment strategy in this patient group. MRI based texture analysis (MRTA) is novel image analysis technique that provides objective information about spatial arrangement of MRI signal intensity (heterogeneity) and has potential to be imaging biomarker.
Objectives |
To investigate MRTA in predicting OS in childhood DMG.
Methods |
Retrospective study of patients diagnosed with DMG, based on radiological features, treated at our institution 2007–2017. MRIs were acquired at diagnosis and 6 weeks after radiotherapy (54Gy in 30 fractions). MRTA was performed using commercial available TexRAD research software on T2W sequence and Apparent Diffusion Coefficient (ADC) maps encapsulating tumour in the largest single axial plane. MRTA comprised filtration-histogram technique using statistical and histogram metrics for quantification of texture. Kaplan-Meier survival analysis determined association of MRI texture parameters with OS.
Results |
In all, 32 children 2–14 years (median 7 years) were included. MRTA was undertaken on T2W (n=32) and ADC (n=22). T2W-MRTA parameters were better at prognosticating than ADC-MRTA. Children with homogenous tumour texture, at medium scale on diagnostic T2W MRI, had worse prognosis (Mean of Positive Pixels (MPP): P=0.005, mean: P=0.009, SD: P=0.011, kurtosis: P=0.037, entropy: P=0.042). Best predictor MPP was able to stratify patients into poor and good prognostic groups with median survival of 7.5 months versus 17.5 months, respectively.
Conclusions |
DMG with more homogeneous texture on diagnostic MRI is associated with worse prognosis. Texture parameter MPP is the most predictive marker of OS in childhood DMG.
Le texte complet de cet article est disponible en PDF.Keywords : Children, Diffuse midline glioma (DMG), Diffuse intrinsic pontine gliomas (DIPG), Magnetic resonance imaging (MRI), MRI based texture analysis (MRTA)
Plan
Vol 48 - N° 4
P. 243-247 - juin 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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