Predicting cancer malignancy and proliferation in glioma patients: intra-subject inter-metabolite correlation analyses using MRI and MRSI contrast scans
Background: The non-invasive characterization of glioma metabolites would greatly assist the management of glioma patients in the clinical setting. This study investigated the applicability of intra-subject inter-metabolite correlation analyses for differentiating glioma malignancy and proliferation. Methods: A total of 17 negative controls (NCs), 39 low-grade gliomas (LGGs) patients, and 25 high-grade gliomas (HGGs) subjects were included in this retrospective study. Amide proton transfer (APT) and magnetization transfer contrast (MTC) imaging contrasts, as well as total choline/total creatine (tCho/tCr) and total N-acetylaspartate/total creatine (tNAA/tCr) ratios quantified from magnetic resonance spectroscopic imaging (MRSI) were co-registered voxel-wise and used to produce three intra-subject inter-metabolite correlation coefficients (IMCCs), namely, R-APT vs. MTC, R-APT vs. tCho/tCr, and R-MTC vs. tNAA/tCr. The correlation between the IMCCs and tumor grade and Ki-67 labeling index (LI) for tumor proliferation were explored. The differences in the IMCCs between the three groups were compared with one-way analysis of variance (ANOVA). Finally, regression analysis was used to build a combined model with multiple IMCCs to improve the diagnostic performance for tumor grades based on receiver operator characteristic curves. Results: Compared with the NCs, gliomas showed stronger inter-metabolic correlations. R-APT vs. MTC was significantly different among the three groups (NC vs. LGGs vs. HGGs: -0.18 +/- 0.38 vs. -0.40 +/- 0.34 vs. -0.70 +/- 0.29, P < 0.0001). No significant differences were detected in R- among the three groups. R-APT vs. MTC and R-APT vs. tCho/tCr correlated significantly with tumor grade (R=-0.41, P=0.001 and R=0.448, P < 0.001, respectively). However, only RAPTvs. MTC was mildly correlated with Ki-67 (R=-0.33, P=0.02). R-APT vs. MTC and R-APT vs. tCho/tCr achieved areas under the curve (AUCs) of 0.754 and 0.71, respectively, for differentiating NCs from gliomas; and 0.77 and 0.78, respectively, for differentiating LGGs from HGGs. The combined multi-IMCCs model improved the correlation with the Ki-67 LI (R=0.46, P=0.0008) and the tumor-grade stratification with AUC increased to 0.85 (sensitivity: 80.0%, specificity: 79.5%). Conclusions: This study demonstrated that glioma patients showed stronger inter-metabolite correlations than control subjects, and the IMCCs were significantly correlated with glioma grade and proliferation. The multiIMCCs combined model further improved the performance of clinical diagnosis.
基金:
National Program of the Ministry of Science and Technology of China during the "12th Five-Year Plan" [2011BAI08B10]; National Natural Science Foundation of China [81171308, 81570462, 81730049]
第一作者单位:[1]Sun Yat Sen Univ, Dept Med Imaging, Canc Ctr, State Key Lab Oncol South China,Collaborat Innova, Guangzhou, Peoples R China
通讯作者:
通讯机构:[2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Radiol, Wuhan, Peoples R China[*1]1095 JieFang Ave, Wuhan 430030, Peoples R China
推荐引用方式(GB/T 7714):
Su Changliang,Li Shihui,Chen Xiaowei,et al.Predicting cancer malignancy and proliferation in glioma patients: intra-subject inter-metabolite correlation analyses using MRI and MRSI contrast scans[J].QUANTITATIVE IMAGING IN MEDICINE AND SURGERY.2021,11(6):2721-2732.doi:10.21037/qims-20-1163.
APA:
Su, Changliang,Li, Shihui,Chen, Xiaowei,Liu, Chengxia,Shaghaghi, Mehran...&Cai, Kejia.(2021).Predicting cancer malignancy and proliferation in glioma patients: intra-subject inter-metabolite correlation analyses using MRI and MRSI contrast scans.QUANTITATIVE IMAGING IN MEDICINE AND SURGERY,11,(6)
MLA:
Su, Changliang,et al."Predicting cancer malignancy and proliferation in glioma patients: intra-subject inter-metabolite correlation analyses using MRI and MRSI contrast scans".QUANTITATIVE IMAGING IN MEDICINE AND SURGERY 11..6(2021):2721-2732