Multicenter imaging outcomes study of The Cancer Genome Atlas glioblastoma patient cohort: imaging predictors of overall and progression-free survival
Despite an aggressive therapeutic approach, the prognosis for most patients with glioblastoma (GBM) remains poor. The aim of this study was to determine the significance of preoperative MRI variables, both quantitative and qualitative, with regard to overall and progression-free survival in GBM. We...
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| Published in: | Neuro-oncology (Charlottesville, Va.) Vol. 17; no. 11; p. 1525 |
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| Main Authors: | , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
01.11.2015
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| Subjects: | |
| ISSN: | 1523-5866, 1523-5866 |
| Online Access: | Get more information |
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| Abstract | Despite an aggressive therapeutic approach, the prognosis for most patients with glioblastoma (GBM) remains poor. The aim of this study was to determine the significance of preoperative MRI variables, both quantitative and qualitative, with regard to overall and progression-free survival in GBM.
We retrospectively identified 94 untreated GBM patients from the Cancer Imaging Archive who had pretreatment MRI and corresponding patient outcomes and clinical information in The Cancer Genome Atlas. Qualitative imaging assessments were based on the Visually Accessible Rembrandt Images feature-set criteria. Volumetric parameters were obtained of the specific tumor components: contrast enhancement, necrosis, and edema/invasion. Cox regression was used to assess prognostic and survival significance of each image.
Univariable Cox regression analysis demonstrated 10 imaging features and 2 clinical variables to be significantly associated with overall survival. Multivariable Cox regression analysis showed that tumor-enhancing volume (P = .03) and eloquent brain involvement (P < .001) were independent prognostic indicators of overall survival. In the multivariable Cox analysis of the volumetric features, the edema/invasion volume of more than 85 000 mm(3) and the proportion of enhancing tumor were significantly correlated with higher mortality (Ps = .004 and .003, respectively).
Preoperative MRI parameters have a significant prognostic role in predicting survival in patients with GBM, thus making them useful for patient stratification and endpoint biomarkers in clinical trials. |
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| AbstractList | Despite an aggressive therapeutic approach, the prognosis for most patients with glioblastoma (GBM) remains poor. The aim of this study was to determine the significance of preoperative MRI variables, both quantitative and qualitative, with regard to overall and progression-free survival in GBM.BACKGROUNDDespite an aggressive therapeutic approach, the prognosis for most patients with glioblastoma (GBM) remains poor. The aim of this study was to determine the significance of preoperative MRI variables, both quantitative and qualitative, with regard to overall and progression-free survival in GBM.We retrospectively identified 94 untreated GBM patients from the Cancer Imaging Archive who had pretreatment MRI and corresponding patient outcomes and clinical information in The Cancer Genome Atlas. Qualitative imaging assessments were based on the Visually Accessible Rembrandt Images feature-set criteria. Volumetric parameters were obtained of the specific tumor components: contrast enhancement, necrosis, and edema/invasion. Cox regression was used to assess prognostic and survival significance of each image.METHODSWe retrospectively identified 94 untreated GBM patients from the Cancer Imaging Archive who had pretreatment MRI and corresponding patient outcomes and clinical information in The Cancer Genome Atlas. Qualitative imaging assessments were based on the Visually Accessible Rembrandt Images feature-set criteria. Volumetric parameters were obtained of the specific tumor components: contrast enhancement, necrosis, and edema/invasion. Cox regression was used to assess prognostic and survival significance of each image.Univariable Cox regression analysis demonstrated 10 imaging features and 2 clinical variables to be significantly associated with overall survival. Multivariable Cox regression analysis showed that tumor-enhancing volume (P = .03) and eloquent brain involvement (P < .001) were independent prognostic indicators of overall survival. In the multivariable Cox analysis of the volumetric features, the edema/invasion volume of more than 85 000 mm(3) and the proportion of enhancing tumor were significantly correlated with higher mortality (Ps = .004 and .003, respectively).RESULTSUnivariable Cox regression analysis demonstrated 10 imaging features and 2 clinical variables to be significantly associated with overall survival. Multivariable Cox regression analysis showed that tumor-enhancing volume (P = .03) and eloquent brain involvement (P < .001) were independent prognostic indicators of overall survival. In the multivariable Cox analysis of the volumetric features, the edema/invasion volume of more than 85 000 mm(3) and the proportion of enhancing tumor were significantly correlated with higher mortality (Ps = .004 and .003, respectively).Preoperative MRI parameters have a significant prognostic role in predicting survival in patients with GBM, thus making them useful for patient stratification and endpoint biomarkers in clinical trials.CONCLUSIONSPreoperative MRI parameters have a significant prognostic role in predicting survival in patients with GBM, thus making them useful for patient stratification and endpoint biomarkers in clinical trials. Despite an aggressive therapeutic approach, the prognosis for most patients with glioblastoma (GBM) remains poor. The aim of this study was to determine the significance of preoperative MRI variables, both quantitative and qualitative, with regard to overall and progression-free survival in GBM. We retrospectively identified 94 untreated GBM patients from the Cancer Imaging Archive who had pretreatment MRI and corresponding patient outcomes and clinical information in The Cancer Genome Atlas. Qualitative imaging assessments were based on the Visually Accessible Rembrandt Images feature-set criteria. Volumetric parameters were obtained of the specific tumor components: contrast enhancement, necrosis, and edema/invasion. Cox regression was used to assess prognostic and survival significance of each image. Univariable Cox regression analysis demonstrated 10 imaging features and 2 clinical variables to be significantly associated with overall survival. Multivariable Cox regression analysis showed that tumor-enhancing volume (P = .03) and eloquent brain involvement (P < .001) were independent prognostic indicators of overall survival. In the multivariable Cox analysis of the volumetric features, the edema/invasion volume of more than 85 000 mm(3) and the proportion of enhancing tumor were significantly correlated with higher mortality (Ps = .004 and .003, respectively). Preoperative MRI parameters have a significant prognostic role in predicting survival in patients with GBM, thus making them useful for patient stratification and endpoint biomarkers in clinical trials. |
| Author | Flanders, Adam Hatami, Masumeh Kirby, Justin Luedi, Markus M Thomas, Ginu Zinn, Pascal O Wangaryattawanich, Pattana Huang, Erich S Holder, Chad A Wintermark, Max Chen, James Y Colen, Rivka R Hwang, Scott N Rubin, Daniel L Wang, Jixin Bakhtiari, Ali Shojaee Freymann, John Hashmi, Syed S |
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Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (P.O.Z.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.O.Z.); Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas (R.R.C.) – sequence: 2 givenname: Masumeh surname: Hatami fullname: Hatami, Masumeh organization: Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.W., M.H., J.W., G.T., A.S.B., M.M.L., R.R.C.); Department of Radiology, Neuroradiology Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (P.W.); Department of Radiology, Division of Neuroradiology/ENT, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (A.F.); Bioinformatics Analyst III, Clinical Monitoring Research Program (CMRP), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Rockville, Maryland (J.K.); Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California (M.W.); Cancer Research, Sage Bionetworks, Seattle, Washington (E.S.H.); Department of Diagnostic and Interventional Imaging, University of Texas Health Sciences Center, Houston, Texas (S.S.H.); Department of Radiology, Stanford University, Stanford, California (D.L.R.); Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); 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Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California (M.W.); Cancer Research, Sage Bionetworks, Seattle, Washington (E.S.H.); Department of Diagnostic and Interventional Imaging, University of Texas Health Sciences Center, Houston, Texas (S.S.H.); Department of Radiology, Stanford University, Stanford, California (D.L.R.); Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (P.O.Z.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.O.Z.); Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas (R.R.C.) – sequence: 16 givenname: Chad A surname: Holder fullname: Holder, Chad A organization: Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.W., M.H., J.W., G.T., A.S.B., M.M.L., R.R.C.); Department of Radiology, Neuroradiology Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (P.W.); Department of Radiology, Division of Neuroradiology/ENT, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (A.F.); Bioinformatics Analyst III, Clinical Monitoring Research Program (CMRP), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Rockville, Maryland (J.K.); Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California (M.W.); Cancer Research, Sage Bionetworks, Seattle, Washington (E.S.H.); Department of Diagnostic and Interventional Imaging, University of Texas Health Sciences Center, Houston, Texas (S.S.H.); Department of Radiology, Stanford University, Stanford, California (D.L.R.); Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (P.O.Z.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.O.Z.); Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas (R.R.C.) – sequence: 17 givenname: Pascal O surname: Zinn fullname: Zinn, Pascal O organization: Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.W., M.H., J.W., G.T., A.S.B., M.M.L., R.R.C.); Department of Radiology, Neuroradiology Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (P.W.); Department of Radiology, Division of Neuroradiology/ENT, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (A.F.); Bioinformatics Analyst III, Clinical Monitoring Research Program (CMRP), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Rockville, Maryland (J.K.); Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California (M.W.); Cancer Research, Sage Bionetworks, Seattle, Washington (E.S.H.); Department of Diagnostic and Interventional Imaging, University of Texas Health Sciences Center, Houston, Texas (S.S.H.); Department of Radiology, Stanford University, Stanford, California (D.L.R.); Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (P.O.Z.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.O.Z.); Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas (R.R.C.) – sequence: 18 givenname: Rivka R surname: Colen fullname: Colen, Rivka R organization: Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.W., M.H., J.W., G.T., A.S.B., M.M.L., R.R.C.); Department of Radiology, Neuroradiology Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (P.W.); Department of Radiology, Division of Neuroradiology/ENT, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (A.F.); Bioinformatics Analyst III, Clinical Monitoring Research Program (CMRP), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Rockville, Maryland (J.K.); Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California (M.W.); Cancer Research, Sage Bionetworks, Seattle, Washington (E.S.H.); Department of Diagnostic and Interventional Imaging, University of Texas Health Sciences Center, Houston, Texas (S.S.H.); Department of Radiology, Stanford University, Stanford, California (D.L.R.); Department of Radiology, University of California San Diego, San Diego, California (J.Y.C.); Neuroradiology Section, St Jude Children's Research Hospital, Memphis, Tennessee (S.N.H.); Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Rockville, Maryland (J.F.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (C.A.H.); Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (P.O.Z.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.O.Z.); Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas (R.R.C.) |
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| Copyright | The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. |
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| Keywords | overall survival glioblastoma imaging TCGA progression free survival |
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| References_xml | – reference: 22214427 - BMC Cancer. 2012;12:3 – reference: 8699228 - J Neurooncol. 1996 Jan;27(1):65-73 – reference: 24997477 - J Neuroradiol. 2015 Jul;42(4):212-21 – reference: 6308989 - AJNR Am J Neuroradiol. 1983 May-Jun;4(3):488-90 – reference: 23392431 - Radiology. 2013 May;267(2):560-9 – reference: 16361543 - Clin Cancer Res. 2005 Dec 15;11(24 Pt 1):8600-5 – reference: 10433106 - J Neurooncol. 1999 May;42(3):227-31 – reference: 18772890 - Nature. 2008 Oct 23;455(7216):1061-8 – reference: 21997991 - Radiographics. 2011 Oct;31(6):1717-40 – reference: 15758010 - N Engl J Med. 2005 Mar 10;352(10):997-1003 – reference: 17889341 - Acad Radiol. 2007 Oct;14(10):1242-51 – reference: 21845561 - Turk Neurosurg. 2011;21(3):271-9 – reference: 10570440 - Cancer. 1999 Nov 15;86(10):2117-23 – reference: 21761969 - J Neurosurg. 2011 Oct;115(4):754-9 – reference: 24772206 - Transl Oncol. 2014 Feb 01;7(1):40-7 – reference: 20887095 - J Neurosurg. 2011 Mar;114(3):587-94 – reference: 18425006 - Neurosurgery. 2008 Mar;62(3):564-76; discussion 564-76 – reference: 16286386 - AJNR Am J Neuroradiol. 2005 Nov-Dec;26(10):2466-74 – reference: 23884657 - J Digit Imaging. 2013 Dec;26(6):1045-57 – reference: 349395 - Natl Cancer Inst Monogr. 1977 Dec;46:189-95 – reference: 11780887 - J Neurosurg. 2001 Aug;95(2):190-8 – reference: 7376822 - Acta Neurol Scand. 1980 Apr;61(4):227-39 – reference: 11382961 - J Magn Reson Imaging. 2001 Jun;13(6):967-75 – reference: 3030531 - Cancer. 1987 May 1;59(9):1617-25 – reference: 19473360 - Eur J Neurol. 2009 Jul;16(7):874-8 – reference: 23354652 - J Neurooncol. 2013 Mar;112(1):91-7 – reference: 20847921 - Surg Neurol Int. 2010 Aug 10;1:null – reference: 15450221 - Med Image Anal. 2004 Sep;8(3):267-74 – reference: 23396489 - Neuro Oncol. 2013 Oct;15(10):1389-94 – reference: 19228619 - N Engl J Med. 2009 Feb 19;360(8):765-73 – reference: 21998659 - PLoS One. 2011;6(10):e25451 – reference: 24990827 - J Neurooncol. 2014 Sep;119(2):429-35 – reference: 25490189 - Radiology. 2015 Apr;275(1):215-27 – reference: 23238158 - Radiology. 2013 Apr;267(1):212-20 – reference: 9212000 - Int J Radiat Oncol Biol Phys. 1997 Apr 1;38(1):27-30 – reference: 9361056 - Neurosurgery. 1997 Nov;41(5):1028-36; discussion 1036-8 – reference: 15758009 - N Engl J Med. 2005 Mar 10;352(10):987-96 – reference: 6260394 - Cancer Clin Trials. 1981;4(1):87-9 |
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| Title | Multicenter imaging outcomes study of The Cancer Genome Atlas glioblastoma patient cohort: imaging predictors of overall and progression-free survival |
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