PDF(Pubmed)
Abstract：
Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its elevated choline (Cho) and decreased N-acetylaspartate (NAA). We present the clinical translatability of spectroscopic imaging with a Cho/NAA ≥ 5x threshold for delineating a biopsy target in a patient diagnosed with non-enhancing glioma. Then, we describe the relationship between the undertreated tumor detected with metabolite imaging and overall survival (OS) from a pilot study of newly diagnosed GBM patients treated with belinostat and chemoradiation. Each cohort (control and belinostat) were split into subgroups using the median difference between pre-radiotherapy Cho/NAA ≥ 2x and the treated T1-weighted contrast-enhanced (T1w-CE) volume. We used the Kaplan-Meier estimator to calculate median OS for each subgroup. The median OS was 14.4 months when the difference between Cho/NAA ≥ 2x and T1w-CE volumes was higher than the median compared with 34.3 months when this difference was lower than the median. The T1w-CE volumes were similar in both subgroups. We find that patients who had lower volumes of undertreated tumors detected via spectroscopy had better survival outcomes.
摘要：
目前神经胶质瘤的诊断和治疗方法具有阻碍生存结果的局限性。我们建议波谱磁共振成像作为标准MRI的辅助手段来弥合这些差距。光谱MRI是一种体积MRI技术，能够基于其升高的胆碱（Cho）和降低的N-乙酰天冬氨酸（NAA）来识别肿瘤浸润。我们提出了Cho/NAA≥5x阈值的光谱成像的临床可翻译性，用于描绘诊断为非增强型神经胶质瘤的患者的活检目标。然后，我们描述了代谢物成像检测到的未治疗肿瘤与接受belinostat和放化疗的新诊断GBM患者的总生存期(OS)之间的关系.使用放疗前Cho/NAA≥2x与治疗的T1加权对比增强（T1w-CE）体积之间的中位数差异，将每个队列（对照组和belinostat）分为亚组。我们使用Kaplan-Meier估计器来计算每个亚组的中位OS。当Cho/NAA≥2x和T1w-CE体积之间的差异高于中位数时，中位OS为14.4个月，而当差异低于中位数时，中位OS为34.3个月。两个亚组的T1w-CE体积相似。我们发现，通过光谱学检测到的未治疗肿瘤体积较低的患者具有更好的生存结果。
