Madison R Hansen1, Edward Pan2, Andrew Wilson3, Morgan McCreary4, Yeqi Wang3, Thomas Stanley3, Marco C Pinho5, Xiaohu Guo3, Darin T Okuda6. 1. Neuroinnovation Program, Multiple Sclerosis & Neuroimmunology Imaging Program, Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Clinical Center for Multiple Sclerosis, 5323 Harry Hines Blvd., Dallas, TX, 75390-8806, USA. 2. Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Simmons Comprehensive Cancer Center, Dallas, TX, USA. 3. Department of Computer Science, University of Texas at Dallas, Dallas, TX, USA. 4. Department of Statistical Science, Baylor University, Waco, TX, USA. 5. Department of Radiology, Southwestern Medical Center, Dallas, TX, USA. 6. Neuroinnovation Program, Multiple Sclerosis & Neuroimmunology Imaging Program, Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Clinical Center for Multiple Sclerosis, 5323 Harry Hines Blvd., Dallas, TX, 75390-8806, USA. darin.okuda@UTsouthwestern.edu.
Abstract
PURPOSE: Pseudoprogression is often indistinguishable from true tumor progression on conventional 2-dimensional (2D) MRI in glioblastoma multiforme (GBM) patients. The aim of this study was to determine the association between post-gadolinium 3-dimensional (3D) characteristics and clinical state in GBM patients. METHODS: Standardized 3D brain MRI studies were performed, and contrast enhancing portions of each tumor were segmented and analyzed, blinded to clinical state, using principal component analysis (PCA), medial axis transformation (MAT), and coverage analysis. Associations between the 3D characteristics of the post-gadolinium enhanced regions and the clinical status of patients were performed. RESULTS: A total of 15 GBM patients [male: 11 (73%); median age (range): 62 years (36-72)] with a median disease duration of 6 months (range 2-24 months) were studied cross-sectionally with 6 (40%) patients identified with tumor progression. Post-gadolinium features corresponding to the group with progressive disease exhibited a more spherical and symmetric shape relative to their stable counterparts (p = 0.005). The predictive value of a more uniformly full post-gadolinium enhanced shell to clinical progression was determined with a sensitivity of 66.7% (95% CI 29.9-92.5), specificity of 100% (54.1-100), and PPV of 100% (p = 0.028, 2-tailed Fisher's exact test). There did not appear to be an association between the thickness of the contrast enhanced shell to clinical state. CONCLUSIONS: The application of 3D technology with post-gadolinium imaging data may inform healthcare providers with new insights into disease states based on spatial, surface, and structural patterns.
PURPOSE: Pseudoprogression is often indistinguishable from true tumor progression on conventional 2-dimensional (2D) MRI in glioblastoma multiforme (GBM) patients. The aim of this study was to determine the association between post-gadolinium 3-dimensional (3D) characteristics and clinical state in GBM patients. METHODS: Standardized 3D brain MRI studies were performed, and contrast enhancing portions of each tumor were segmented and analyzed, blinded to clinical state, using principal component analysis (PCA), medial axis transformation (MAT), and coverage analysis. Associations between the 3D characteristics of the post-gadolinium enhanced regions and the clinical status of patients were performed. RESULTS: A total of 15 GBM patients [male: 11 (73%); median age (range): 62 years (36-72)] with a median disease duration of 6 months (range 2-24 months) were studied cross-sectionally with 6 (40%) patients identified with tumor progression. Post-gadolinium features corresponding to the group with progressive disease exhibited a more spherical and symmetric shape relative to their stable counterparts (p = 0.005). The predictive value of a more uniformly full post-gadolinium enhanced shell to clinical progression was determined with a sensitivity of 66.7% (95% CI 29.9-92.5), specificity of 100% (54.1-100), and PPV of 100% (p = 0.028, 2-tailed Fisher's exact test). There did not appear to be an association between the thickness of the contrast enhanced shell to clinical state. CONCLUSIONS: The application of 3D technology with post-gadolinium imaging data may inform healthcare providers with new insights into disease states based on spatial, surface, and structural patterns.
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Authors: Darin T Okuda; Tatum M Moog; Morgan McCreary; Jennifer N Bachand; Andrew Wilson; Katy Wright; Mandy D Winkler; Osniel Gonzalez Ramos; Aiden P Blinn; Yeqi Wang; Thomas Stanley; Marco C Pinho; Braeden D Newton; Xiaohu Guo Journal: Sci Rep Date: 2020-11-11 Impact factor: 4.379