Predictive value of contrast-enhanced T1 weighted imaging texture parameters combined with clinicopathological features in postoperative recurrence of glioma
Xie Gang1,2, Tang Wuli1, Liu Jun3, Li Kang1
1Department of Radiology, Chongqing General Hospital, Chongqing 401147, China; 2School of Medical Imaging,North Sichuan Medical College, Nanchong 637000, China; 3Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
Abstract:Objective This study aimed to investigate the predictive value of contrast-enhanced T1 weighted imaging (cT1WI) texture parameters combined with clinicopathological features in postoperative recurrence of glioma. Methods This work was a retrospective cohort study. A total of 90 patients with brain gliomas diagnosed pathologically after operation were included in the Affiliated Hospital of North Sichuan Medical College and Chongqing General Hospital from January 2018 to February 2021. The patients comprised 60 males and 30 females, with an age range of 17-76 (47±14) years. Within 1 year after operation, 46 cases recurred and 44 cases did not. The patients were randomly divided into the training set and verification set following the ratio of 2∶1. The texture parameters of glioma were extracted from preoperative cT1WI by Mazda software. In the training set, the texture parameters were screened, and the prognostic texture score was established by using the least absolute shrinkage and selection operator. Factor analysis was performed on the clinicopathological characteristics and texture score of patients with recurrence and non-recurrence within 1 year after operation in the training set. A visual combined prediction model was then constructed. (1) The risk factors of glioma recurrence within 1 year after operation were analyzed, and a combined prediction model was established. (2) In the verification set, the texture score and combined prediction model were verified. Receiver operating characteristic curve, calibration curve, and decision curve analysis were used to evaluate the diagnostic efficacy and clinical net benefit of the model. Results Univariate analysis showed that WHO grade, isocitrate dehydrogenase-1 mutation, postoperative chemoradiotherapy, and texture score were the influencing factors of glioma recurrence within 1 year after operation. Multivariate analysis showed that all of them were independent risk factors for the recurrence of glioma within 1 year after operation (odds ratio [OR]=6.527, 0.160, 0.052,and 6.300; 95% confidence interval [CI]=1.201-35.485, 0.031-0.827, 0.004-0.708, and 1.905-20.841; P =0.030, 0.029, 0.026, and 0.003). The efficiency of the combined model in predicting the recurrence of glioma within 1 year after operation was higher than that of the texture score model. In the combined model, the training and verification sets had area under curve (AUCs) of 0.92 (95% CI 0.86-0.99) and 0.86 (95% CI 0.74-0.99), sensitivity of 0.90 and 0.88, and specificity of 0.83 and 0.79, respectively. In the texture score model, the training and verification sets had AUCs of 0.85 (95% CI 0.75-0.95) and 0.82 (95% CI 0.67-0.97), sensitivity of 0.73 and 0.63, and specificity of 0.90 and 0.99, respectively. In the two prediction models, the consistency between prediction probability and actual probability and clinical net benefit was quite good. Conclusion The combined model based on the texture parameters of preoperative cT1WI and clinicopathological features has good predictive value for the recurrence of glioma within 1 year after total resection.
谢刚, 唐伍丽, 刘军, 李康. T1WI增强纹理参数联合临床病理学特征对脑胶质瘤患者术后1年内复发的预测价值研究[J]. 中华解剖与临床杂志, 2022, 27(8): 539-544.
Xie Gang, Tang Wuli, Liu Jun, Li Kang. Predictive value of contrast-enhanced T1 weighted imaging texture parameters combined with clinicopathological features in postoperative recurrence of glioma. Chinese Journal of Anatomy and Clinics, 2022, 27(8): 539-544.
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