Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma

Abstract Glioblastoma is the most common primary brain tumor. Standard therapy consists of maximum safe resection combined with adjuvant radiochemotherapy followed by chemotherapy with temozolomide, however prognosis is extremely poor. Assessment of the residual tumor after surgery and patient strat...

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Autores principales:	Alonso Garcia-Ruiz, Pablo Naval-Baudin, Marta Ligero, Albert Pons-Escoda, Jordi Bruna, Gerard Plans, Nahum Calvo, Monica Cos, Carles Majós, Raquel Perez-Lopez
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8bd6ad5684ac4d938d88553a2be568f0
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spelling	oai:doaj.org-article:8bd6ad5684ac4d938d88553a2be568f02021-12-02T14:01:37ZPrecise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma10.1038/s41598-020-79829-32045-2322https://doaj.org/article/8bd6ad5684ac4d938d88553a2be568f02021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79829-3https://doaj.org/toc/2045-2322Abstract Glioblastoma is the most common primary brain tumor. Standard therapy consists of maximum safe resection combined with adjuvant radiochemotherapy followed by chemotherapy with temozolomide, however prognosis is extremely poor. Assessment of the residual tumor after surgery and patient stratification into prognostic groups (i.e., by tumor volume) is currently hindered by the subjective evaluation of residual enhancement in medical images (magnetic resonance imaging [MRI]). Furthermore, objective evidence defining the optimal time to acquire the images is lacking. We analyzed 144 patients with glioblastoma, objectively quantified the enhancing residual tumor through computational image analysis and assessed the correlation with survival. Pathological enhancement thickness on post-surgical MRI correlated with survival (hazard ratio: 1.98, p < 0.001). The prognostic value of several imaging and clinical variables was analyzed individually and combined (radiomics AUC 0.71, p = 0.07; combined AUC 0.72, p < 0.001). Residual enhancement thickness and radiomics complemented clinical data for prognosis stratification in patients with glioblastoma. Significant results were only obtained for scans performed between 24 and 72 h after surgery, raising the possibility of confounding non-tumor enhancement in very early post-surgery MRI. Regarding the extent of resection, and in agreement with recent studies, the association between the measured tumor remnant and survival supports maximal safe resection whenever possible.Alonso Garcia-RuizPablo Naval-BaudinMarta LigeroAlbert Pons-EscodaJordi BrunaGerard PlansNahum CalvoMonica CosCarles MajósRaquel Perez-LopezNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alonso Garcia-Ruiz Pablo Naval-Baudin Marta Ligero Albert Pons-Escoda Jordi Bruna Gerard Plans Nahum Calvo Monica Cos Carles Majós Raquel Perez-Lopez Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
description	Abstract Glioblastoma is the most common primary brain tumor. Standard therapy consists of maximum safe resection combined with adjuvant radiochemotherapy followed by chemotherapy with temozolomide, however prognosis is extremely poor. Assessment of the residual tumor after surgery and patient stratification into prognostic groups (i.e., by tumor volume) is currently hindered by the subjective evaluation of residual enhancement in medical images (magnetic resonance imaging [MRI]). Furthermore, objective evidence defining the optimal time to acquire the images is lacking. We analyzed 144 patients with glioblastoma, objectively quantified the enhancing residual tumor through computational image analysis and assessed the correlation with survival. Pathological enhancement thickness on post-surgical MRI correlated with survival (hazard ratio: 1.98, p < 0.001). The prognostic value of several imaging and clinical variables was analyzed individually and combined (radiomics AUC 0.71, p = 0.07; combined AUC 0.72, p < 0.001). Residual enhancement thickness and radiomics complemented clinical data for prognosis stratification in patients with glioblastoma. Significant results were only obtained for scans performed between 24 and 72 h after surgery, raising the possibility of confounding non-tumor enhancement in very early post-surgery MRI. Regarding the extent of resection, and in agreement with recent studies, the association between the measured tumor remnant and survival supports maximal safe resection whenever possible.
format	article
author	Alonso Garcia-Ruiz Pablo Naval-Baudin Marta Ligero Albert Pons-Escoda Jordi Bruna Gerard Plans Nahum Calvo Monica Cos Carles Majós Raquel Perez-Lopez
author_facet	Alonso Garcia-Ruiz Pablo Naval-Baudin Marta Ligero Albert Pons-Escoda Jordi Bruna Gerard Plans Nahum Calvo Monica Cos Carles Majós Raquel Perez-Lopez
author_sort	Alonso Garcia-Ruiz
title	Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
title_short	Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
title_full	Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
title_fullStr	Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
title_full_unstemmed	Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
title_sort	precise enhancement quantification in post-operative mri as an indicator of residual tumor impact is associated with survival in patients with glioblastoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8bd6ad5684ac4d938d88553a2be568f0
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Precise enhancement quantification in post-operative MRI as an indicator of residual tumor impact is associated with survival in patients with glioblastoma

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