Fatima Tensaouti1, Anne Ducassou2, Léonor Chaltiel3, Annick Sevely4, Stéphanie Bolle5, Xavier Muracciole6, Bernard Coche-Dequant7, Claire Alapetite8, Stéphane Supiot9, Aymeri Huchet10, Valérie Bernier11, Line Claude12, Anne-Isabelle Bertozzi-Salamon13, Samuel Liceaga1, Jean Albert Lotterie1,14, Patrice Péran1, Pierre Payoux1,15, Anne Laprie1,2. 1. 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France. 2. 2 Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France. 3. 3 Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. 4. 4 Department of Radiology, CHU Purpan, Toulouse, France. 5. 5 Department of Radiation Oncology, Institut Gustave Roussy, Paris, France. 6. 6 Department of Radiation Oncology, CHU La Timone, Marseille, France. 7. 7 Department of Radiation Oncology, Centre Oscar Lambret, Lille, France. 8. 8 Department of Radiation Oncology, Institut Curie, Paris, France. 9. 9 Department of Radiation Oncology, Institut de cancérologie de l'ouest, Nantes, France. 10. 10 Department of Radiation Oncology, CHU Bordeaux, Bordeaux, France. 11. 11 Department of Radiation Oncology, Centre Alexis Vautrin, Vandoeuvre, Nancy, France. 12. 12 Department of Radiation Oncology, Centre Léon Bérard, Lyon, France. 13. 13 Department of pediatric, Hematology-Oncology Unit, CHU Purpan, Toulouse, France. 14. 14 Department of Nuclear Medicine, CHU Rangueil, Toulouse, France. 15. 15 Department of Nuclear Medicine, CHU Purpan, Toulouse, France.
Abstract
OBJECTIVE: To assess the relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) derived, respectively, from perfusion and diffusion pre-operative MRI of intracranial ependymomas and their predictive and prognostic values. METHODS: Pre-operative MRI and clinical data for intracranial ependymomas diagnosed between January 2000 and December 2013 were retrospectively retrieved from a web-based national database. MRI data included diffusion (62 patients) and perfusion (20 patients) MRI. Patient age, histopathological diagnosis, tumour location, ADC, relative ADC (rADC) and rCBV were considered as potential factors in a survival analysis. Survival rates were estimated using the Kaplan-Meier method. Univariate analyses were performed using the log-rank test to compare groups. We also performed a multivariate analysis, applying the Cox proportional hazards model. RESULTS: ADC and rADC values within hypointense regions differed significantly between grades II and III (p = 0.01). The 75th percentile of ADC within hypointense regions and the 25th percentile of rCBV within non-enhancing lesions were prognostic of disease-free survival (p = 0.004, p = 0.05). A significant correlation was found between the 75th percentile of rCBV and the 25th percentile of rADC (p = 0.01) in enhancing regions of grade-III tumours. CONCLUSION: Pre-operative rADC and rCBV could be used as prognostic factors for clinical outcome and to predict histological grade in paediatric ependymomas. ADVANCES IN KNOWLEDGE: Prognostic value of diffusion and perfusion MRI in paediatric ependymoma was found and may play a role in the prognostic classification of patients in order to design more tailored treatment strategies.
OBJECTIVE: To assess the relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) derived, respectively, from perfusion and diffusion pre-operative MRI of intracranial ependymomas and their predictive and prognostic values. METHODS: Pre-operative MRI and clinical data for intracranial ependymomas diagnosed between January 2000 and December 2013 were retrospectively retrieved from a web-based national database. MRI data included diffusion (62 patients) and perfusion (20 patients) MRI. Patient age, histopathological diagnosis, tumour location, ADC, relative ADC (rADC) and rCBV were considered as potential factors in a survival analysis. Survival rates were estimated using the Kaplan-Meier method. Univariate analyses were performed using the log-rank test to compare groups. We also performed a multivariate analysis, applying the Cox proportional hazards model. RESULTS: ADC and rADC values within hypointense regions differed significantly between grades II and III (p = 0.01). The 75th percentile of ADC within hypointense regions and the 25th percentile of rCBV within non-enhancing lesions were prognostic of disease-free survival (p = 0.004, p = 0.05). A significant correlation was found between the 75th percentile of rCBV and the 25th percentile of rADC (p = 0.01) in enhancing regions of grade-III tumours. CONCLUSION: Pre-operative rADC and rCBV could be used as prognostic factors for clinical outcome and to predict histological grade in paediatric ependymomas. ADVANCES IN KNOWLEDGE: Prognostic value of diffusion and perfusion MRI in paediatric ependymoma was found and may play a role in the prognostic classification of patients in order to design more tailored treatment strategies.
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