Pre- and post-surgery MRSI predictive value in adult oligodendroglioma prognosis

Publication date: Available online 11 June 2018
Source:Magnetic Resonance Imaging
Author(s): Caroline Bund, François Lefebvre, Roland Schott, Marie-Pierre Chenard, Benoît Lhermitte, Hélène Cebula, Stéphane Kremer, François Proust, Izzie-Jacques Namer
PurposeThe aim of this study was to study the relationship between MRSI, before and after surgery, and patient survival. The accuracy of pre-operative MRSI in differentiating low- from high-grade oligodendrogliomas (ODGs) was also studied.MethodsTwo hundred patients with ODG were retrospectively included in this study between 2000 and 2016. All patients underwent MRSI before any treatment or biopsy and/or after surgery for an intra-axial brain tumour. The R software was used for statistical data analysis. p < 0.05 was considered statistically significant. Kaplan-Meier curves were calculated for patients with low-grade ODG and high-grade ODG pre- and post-operatively, to study survival (overall survival, OS). The best threshold of each MRSI metabolite ratio was obtained using receiver operating characteristic curves (ROCs).ResultsOne hundred patients underwent pre-operative MRSI and 170 post-operative MRSI. N-acetylaspartate (NAA), lactate (Lac), choline (Cho) and creatine (Cr) were measured. Kapan-Meier curves showed that survival was poorer for a nCho/Cr > 3.02 in the pre-operative and nCho/Cr > 2.04, Lac/Cr > 0.743 and nCho/NAA > 3.63 in the post-operative period. Post-operative MRSI predicts survival better than pre-operative MRSI. nCho/Cr and Lac/Cr distinguished low- from high-grade ODG with a good positive predictive value.ConclusionMRSI is associated with survival. It is a non-invasive tool which completes histopathology and can predict patients' prognosis, thus improving patient management.



https://ift.tt/2HGmC2r