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MRI biomarkers of primary CNS lymphoma outcome after MATRix: real world performance
Nitin Menon1, Isabelle Naylor2, Emmanuel Buba1
1Neuroradiology Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Introduction:
Despite treatment advances, accurate prognostication for patients with newly diagnosed primary central nervous system lymphoma (PCNSL) remains unsatisfactory. This retrospective cohort study evaluated whether T1 contrast-enhanced (T1CE) tumour volume and apparent diffusion coefficient (ADC) metrics on magnetic resonance imaging (MRI) predict survival in PCNSL patients treated uniformly with MATRix chemotherapy.
Methods:
Sixty-five patients underwent pre-treatment MRI with volumetric and diffusion analysis. T1CE tumour volume, ADCmean, ADCmin and normalised diffusion parameters were assessed. Survival outcomes were analysed using univariate Cox regression for overall survival (OS) and progression-free survival (PFS), including disease-specific endpoints.
Results:
None of the tested imaging variables were significantly associated with OS or PFS, including T1CE tumour volume and ADC measures. Baseline T1CE and diffusion biomarkers did not predict survival in MATRix-treated PCNSL.
Discussion:
These results highlight limitations of standard MRI techniques for prognostication underscoring the need for integrated multiparametric models incorporating imaging and biological data to improve outcome prediction.
