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  • Oxford University Press (OUP)  (3)
  • Okita, Yoshiko  (3)
  • 1
    In: Neuro-Oncology Advances, Oxford University Press (OUP)
    Abstract: The study aims to explore MRI phenotypes that predict glioblastoma’s (GBM) methylation status of the promoter region of MGMT gene (pMGMT) by qualitatively assessing contrast-enhanced T1-weighted intensity images. Methods One hundred Ninety-three histologically and molecularly confirmed GBMs at the Kansai Network for Molecular Diagnosis of Central Nervous Tumors (KANSAI) were used as an exploratory cohort. Ninety-three patients from the Cancer Imaging Archive (TCIA) / Cancer Genome Atlas (TCGA) were used as validation cohorts. “Thickened structure” was defined as the solid tumor component presenting circumferential extension or occupying & gt;50% of the tumor volume. “Methylated contrast phenotype” was defined as indistinct enhancing circumferential border, heterogenous enhancement, or nodular enhancement. Inter-rater agreement was assessed, followed by an investigation of the relationship between radiological findings and pMGMT methylation status. Results Fleiss’s Kappa coefficient for “Thickened structure” was 0.68 for the exploratory and 0.55 for the validation cohort, and for “Methylated contrast phenotype,” 0.30 and 0.39, respectively. The imaging feature, the presence of “Thickened structure” and absence of “Methylated contrast phenotype,” was significantly predictive of pMGMT unmethylation both for the exploratory (p = 0.015, odds ratio = 2.44) and for the validation cohort (p = 0.006, odds ratio = 7.83). The sensitivities and specificities of the imaging feature, the presence of “Thickened structure,” and the absence of “Methylated contrast phenotype” for predicting pMGMT unmethylation were 0.29 and 0.86 for the exploratory and 0.25 and 0.96 for the validation cohort. Conclusion The present study showed that qualitative assessment of contrast-enhanced T1-weighted intensity images helps predict GBM’s pMGMT methylation status.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 3009682-0
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  • 2
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 2, No. Supplement_3 ( 2020-11-28), p. ii14-ii14
    Abstract: Introduction: Clinical application of survival prediction of primary glioblastoma (pGBM) using preoperative images remains challenging due to a lack of robustness and standardization of the method. This research focused on validating a machine learning-based texture analysis model for this purpose using internal and external cohorts. Method: We included all cases of IDH wild-type pGBM available of preoperative MRI (T1WI, T2WI, and Gd-T1WI) from the databases of Kansai Molecular Diagnosis Network for CNS tumors (KN) and The Cancer Genome Atlas (TCGA). Of 242 cases from KN, we assigned 137 cases as a training dataset (D1), and the remaining 105 cases as an internal validation dataset (D2). Furthermore, we extracted 96 cases from TCGA as an external validation dataset (D3). Preoperative MRI scans were semi-quantitatively analyzed, leading to the acquisition of 489 texture features as explanatory variables. Dichotomous overall survival (OS) with a 16.6 months cutoff was regarded as the response variable (short/long OS). We employed Lasso regression for feature selection, and a survival prediction model constructed for D1 via cross-validation (M1) was applied to D2 and D3 to ensure the model robustness. Results: The population of predicted short OS by M1 significantly showed poorer prognosis in D2 (median OS 11.1 vs. 19.4 months; log-rank test, p=0.03), while there was no significant difference in D3 (median OS 14.2 vs. 11.9 months; p=0.61). In the comparative analysis using t-SNE, there was little variation in the feature distribution among three datasets. Conclusion: We were able to validate the prediction model in the internal but not in the external cohort. The presented result supports the use of machine learning-based texture analysis for survival prediction of pGBM in a localized population or country. However, further consideration is required to achieve a universal prediction model for pGBM, irrespective of regional difference.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 3009682-0
    Location Call Number Limitation Availability
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  • 3
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 2, No. Supplement_3 ( 2020-11-28), p. ii11-ii12
    Abstract: BACKGROUND: Geriatric neuro-oncology is an important research field, because the elderly patients is growing at a very rapid rate. This study investigates molecular features and their prognostic effects in the elderly glioblastomas (GBM). METHODS: We collected adult cases diagnosed with IDH-wildtype GBM and enrolled in Kansai Molecular Diagnosis Network for CNS Tumors (212 cases). Clinical and molecular features were analyzed retrospectively and independent prognostic factors were identified statistically. Focusing on the elderly ( & gt;=70 years) cases, the association between molecular factors and overall survivals (OS) was examined. RESULTS: Included in the study were 92 elderly cases (43.4%) and median OS was 12.8 months. MGMT promoter was methylated in 50 (54.3%). Triple CNA (EGFR amplification/gain & PTEN deletion & CDKN2A deletion) was detected in 23 (25.0%). NFKBIA was deleted in 23 (25.0%). In the elderly cases, adjuvant radiation and temozolomide (RT+TMZ) was performed in 39 (42.4%) (mOS = 17.1 months). Statistical analyses of the elderly plus non-elderly cases treated with RT+TMZ (148 cases), MGMT promoter, triple CNA and NFKBIA were identified as independent molecular prognostic factors. In the elderly group, however, there was no significant difference in OS according to MGMT status (methylated = 18.7 vs. unmethylated = 17.1, p = 0.3885) or triple CNA status (triple = 13.6 vs. non-triple = 19.6, p = 0.1734). On the other hand, statistical difference was observed according to NFKBIA status (del = 12.1 vs. non-del = 18.7, p = 0.0157*) even in the elderly cases. CONCLUSION: Prognostic effects of molecular factors might be attenuated in the elderly patients. Further investigation in a larger population is necessary.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 3009682-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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