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• Clinical Article •
Clinical study of preoperative conventional magnetic resonance imaging to predict the recurrence site of glioma
LI Qian  HU Xiaofei  SHI Yu  WANG Jian 

LI Q, HU X F, SHI Y, et al. Clinical study of preoperative conventional magnetic resonance imaging to predict the recurrence site of glioma[J]. Chin J Magn Reson Imaging, 2023, 14(8): 19-26. DOI:10.12015/issn.1674-8034.2023.08.003.


[Abstract] Objective To predict the recurrence of glioma after surgery through preoperative conventional magnetic resonance imaging signs, so as to help clinicians planning more accurate surgical resection range before surgery.Materials and Methods This study is a retrospective study, involving 123 patients with postoperative recurrence of glioma confirmed by pathology in two centers, all of whom have complete preoperative and postoperative MRI images of recurrence. Two radiologists established a plane rectangular coordinate system with the center of the preoperative and postoperative glioma as the midpoint, thus dividing the tumor into four quadrants, respectively evaluating the MR imaging signs of the four quadrants before surgery and whether the quadrant recurred after surgery, and performing interrater reliability (IRR) analysis on the two radiologists; 18 MRI manifestations of Visually Accessible Rembrandt Images (VASAIR) signs were selected as the predictive index variables. The binary logistic regression is used as a classifier to build the prediction model, and the cross-validation method is used to verify the prediction ability of the model, where the training set∶validation set=3∶1; Select meaningful variables to establish a nomogram, and use concordance index curve and decision curve analysis (DCA) to verify.Results One hundred and twenty three patients were divided into four quadrants, a total of 492 quadrants. They were randomly divided into training set (129 non-recurrent quadrants and 240 recurrent quadrants) and validation set (43 non-recurrent quadrants and 80 recurrent quadrants). There were statistically significant differences in the enhancement quality (P=0.03), unenhanced diameter line (P＜0.01), deep white matter invasion (P=0.02), unenhanced area crosses midline (P=0.04), ependymal invasion (P＜0.01), the T1WI/fluid-attenuated inversion-recovery (FLAIR) (P=0.02). Further establish logistic regression model. The area under the receiver operating characteristic (ROC) curve in the training set is 0.7642 (P＜0.05), and the Kappa value is 0.38. The area under the ROC curve in the validation set data is 0.8493 (P＜0.05), and the Kappa value is 0.56.Conclusions Enhancement quality, unenhanced diameter line, deep white matter invasion, unenhanced area crosses midline, ependymal invasion, and T1WI/FLAIR in the VASAIR feature concentration can predict glioma recurrence and recurrence site (quadrant) before surgery, which is helpful for neurosurgeons to make surgical plans.
[Keywords] glioma；magnetic resonance imaging；recurrence；quadrant；predict

LI Qian1, 2   HU Xiaofei3   SHI Yu4   WANG Jian1*  

1 Department of Radiology, the Southwest Hospital of AMU, Chongqing 400037, China

2 Department of Radiology, 958th Army Hospital, Chongqing 400020, China

3 Department of Nuclear Medicine, the Southwest Hospital of AMU, Chongqing 400037, China

4 Department of Pathology, the Southwest Hospital of AMU, Chongqing 400037, China

Corresponding author: Wang J, E-mail: wangjian_811@foxmail.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 92059103); Sichuan Provincial Regional Innovation Cooperation Project (No. 2023YFQ0002).
Received  2023-03-22
Accepted  2023-07-27
DOI: 10.12015/issn.1674-8034.2023.08.003
LI Q, HU X F, SHI Y, et al. Clinical study of preoperative conventional magnetic resonance imaging to predict the recurrence site of glioma[J]. Chin J Magn Reson Imaging, 2023, 14(8): 19-26. DOI:10.12015/issn.1674-8034.2023.08.003.

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