P14.17 Conventional MRI criteria differentiate true tumour progression from treatment-induced effects in irradiated WHO grade 3 and 4 gliomas
العنوان: | P14.17 Conventional MRI criteria differentiate true tumour progression from treatment-induced effects in irradiated WHO grade 3 and 4 gliomas |
---|---|
المؤلفون: | Pierre A. Robe, Jan Willem Dankbaar, F.Y.F.L. De Vos, Joost J.C. Verhoeff, Tatjana Seute, C M Flies, Jeroen Hendrikse, T D Witkamp, K H van Leuken, Tom J. Snijders |
المصدر: | Neuro Oncol |
بيانات النشر: | Oxford University Press (OUP), 2021. |
سنة النشر: | 2021 |
مصطلحات موضوعية: | Poster Presentations, Cancer Research, Oncology, business.industry, Neurology (clinical), Who grade, Nuclear medicine, business |
الوصف: | BACKGROUND Post-treatment radiological deterioration of patients with an irradiated high-grade (WHO grade 3 and 4) glioma (HGG) may be the result of true progressive disease (PD) or treatment-induced effects (TIE). Differentiation between these two entities is of great importance, but remains a diagnostic challenge. This study assesses the diagnostic value of conventional MRI characteristics to differentiate PD from TIE in treated HGGs. MATERIAL AND METHODS In this single-centre, retrospective cohort study, we included adult patients with a HGG, who were treated with radiotherapy and subsequently developed a new or increasing contrast-enhancing lesion on conventional follow-up MRI. TIE and PD were defined radiologically as stable/decreased for a minimum of six weeks or progressive according to the RANO criteria, and histologically as predominantly TIE without viable tumour or PD. Demographic and clinical data were retrieved. Twenty-one preselected MRI characteristics of the progressive lesions were assessed by two neuroradiologists. The statistical analysis included logistic regression to develop a) a full multivariable model b) a diagnostic model with model reduction, and a Cohen’s Kappa interrater reliability coefficient. RESULTS 210 patients (median age 61, IQR=54–68, 189 males) with 284 lesions were included, of which 141 (50%) had PD. Median time to PD was 2 (0.7–6.1) and to TIE 0.9 (0.7–3.5) months after RT. In multivariable modelling and after model reduction, the following determinants were significant diagnostic factors: Radiation dose (Odds ratio (OR)=0.68, p=0.017), longer time since radiotherapy (OR=3.56, p1 indicate higher odds of PD. The Hosmer & Lemeshow test showed a good calibration (p=0.947) and the area under the ROC-curve was 0.722 (95%-CI=0.66–0.78). Interrater reliability analysis between neuroradiologists revealed moderate to near-perfect agreement for the significantly predictive items, but poor agreement for others. CONCLUSION In patients with irradiated high-grade gliomas, several characteristics from conventional MRI are significant predictors for the discrimination between true progression and treatment-induced effects. Interrater reliability for these characteristics was variable. Conventional MRI characteristics from this study should be incorporated into a multimodal diagnostic model that includes advanced imaging techniques. FUNDING INFORMATION Foundation Vrienden UMC Utrecht and The StophersenkankerNU Foundation. |
تدمد: | 1523-5866 1522-8517 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::96d545c3b016fcc1819e45d79a4776a4 https://doi.org/10.1093/neuonc/noab180.140 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....96d545c3b016fcc1819e45d79a4776a4 |
قاعدة البيانات: | OpenAIRE |
تدمد: | 15235866 15228517 |
---|