使用多参数核磁共振和基于瘤内异质性的息地成像来预先预测基-67表达和质瘤风险分层:一项多中心研究
Xingrui Wang1, Hao Wu2, Yuanzheng Wang1
1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International journal of surgery (London, England)
|October 24, 2025
概括
多参数MRI通过识别瘤内部息地,非侵入性地预测质瘤扩散 (Ki-67) 和患者风险. 这种成像方法有助于分层患者和个性化治疗计划,以获得更好的结果.
科学领域:
- 神经成像是一种神经成像.
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 质瘤是具有可变Ki-67增殖指数 (PI) 的原发性脑瘤.
- 内瘤异质性 (ITH) 显著影响质瘤生物学和患者预后.
- 对ITH和PI的非侵入性评估对于准确的诊断和治疗计划至关重要.
研究的目的:
- 评估多参数MRI用于评估质瘤中的ITH.
- 使用MRI衍生的特征来非侵入性地预测Ki-67 PI.
- 为了确定基于MRI的ITH在质瘤的预后意义.
主要方法:
- 205名质瘤患者接受了动态对比增强型MRI (DCE-MRI) 和扩散权重成像 (DWI).
- 瘤被分为三个息地,基于Ktrans和ADC值,使用k-means集群.
- 机器学习模型 (逻辑回归,弹性网) 预测了Ki-67 PI;通过生存分析评估的预后值.
主要成果:
- 根据血管透性和细胞性确定了三个不同的瘤内息地 (H1,H2,H3).
- 弹性网模型在预测Ki-67PI时取得了高准确度 (AUC为0.869-0.924).
- 综合风险评分对患者进行了分层,高风险人群的无进展生存期 (PFS) 和整体生存期 (OS) 显著缩短.
结论:
- 基于MRI的多参数息地成像能够准确地进行手术前的非侵入性预测,对质瘤中Ki-67的表达进行预测.
- 这种方法促进了风险分层,并提供了对瘤生物学的见解.
- 这些发现支持在质瘤管理中进行个性化治疗规划的可能性.
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