Combined use of susceptibility weighted magnetic resonance imaging sequences and dynamic susceptibility contrast perfusion weighted imaging to improve the accuracy of the differential diagnosis of recurrence and radionecrosis in high-grade glioma patients
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Title
- Combined use of susceptibility weighted magnetic resonance imaging sequences and dynamic susceptibility contrast perfusion weighted imaging to improve the accuracy of the differential diagnosis of recurrence and radionecrosis in high-grade glioma patients
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Author(s)
- Tae-Hyung Kim; Tae Jin Yun; Chul-Kee Park; Tae Min Kim; Ji-Hoon Kim; Chul-Ho Sohn; Jae Kyung Won; Sung-Hye Park; Il Han Kim; Seung Hong Choi
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Subject
- magnetic resonance imaging, ; radionecrosis, recurrence, ; susceptibility-weighted magnetic resonance imaging sequences, ; dynamic susceptibility contrast perfusion-weighted imaging
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Publication Date
- 2017-03
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Journal
- ONCOTARGET, v.8, no.12, pp.20340 - 20353
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Publisher
- IMPACT JOURNALS LLC
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Abstract
- Purpose was to assess predictive power for overall survival (OS) and diagnostic
performance of combination of susceptibility-weighted MRI sequences (SWMRI)
and dynamic susceptibility contrast (DSC) perfusion-weighted imaging (PWI) for
differentiation of recurrence and radionecrosis in high-grade glioma (HGG). We
enrolled 51 patients who underwent radiation therapy or gamma knife surgery
followed by resection for HGG and who developed new measurable enhancement more
than six months after complete response. The lesions were confirmed as recurrence (n
= 32) or radionecrosis (n = 19). The mean and each percentile value from cumulative
histograms of normalized CBV (nCBV) and proportion of dark signal intensity on
SWMRI (proSWMRI, %) within enhancement were compared. Multivariate regression
was performed for the best differentiator. The cutoff value of best predictor from ROC
analysis was evaluated. OS was determined with Kaplan-Meier method and log-rank
test. Recurrence showed significantly lower proSWMRI and higher mean nCBV and
90th percentile nCBV (nCBV90) than radionecrosis. Regression analysis revealed both
nCBV90 and proSWMRI were independent differentiators. Combination of nCBV90 and
proSWMRI achieved 71.9% sensitivity (23/32), 100% specificity (19/19) and 82.3%
accuracy (42/51) using best cut-off values (nCBV90 > 2.07 and proSWMRI≤15.76%)
from ROC analysis. In subgroup analysis, radionecrosis with nCBV > 2.07 (n = 5)
showed obvious hemorrhage (proSWMRI > 32.9%). Patients with nCBV90 > 2.07 and
proSWMRI≤15.76% had significantly shorter OS. In conclusion, compared with DSC
PWI alone , combination of SWMRI and DSC PWI have potential to be prognosticator
for OS and lower false positive rate in differentiation of recurrence and radionecrosis
in HGG who develop new measurable enhancement more than six months after
complete response.
Copyright ⓒ 2017 Impact Journals Impact Journals is a rigistered trademark of Impact Journals,LLC
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URI
- https://pr.ibs.re.kr/handle/8788114/3512
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DOI
- 10.18632/oncotarget.13050
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ISSN
- 1949-2553
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Appears in Collections:
- Center for Nanoparticle Research(나노입자 연구단) > 1. Journal Papers (저널논문)
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