Authors: Nicholas Czarnek Kal Clark Katherine B Peters Maciej A Mazurowski
Publish Date: 2017/01/10
Volume: 132, Issue: 1, Pages: 55-62
Abstract
In this retrospective IRBexempt study we analyzed data from 68 patients diagnosed with glioblastoma GBM in two institutions and investigated the relationship between tumor shape quantified using algorithmic analysis of magnetic resonance images and survival Each patient’s Fluid Attenuated Inversion Recovery FLAIR abnormality and enhancing tumor were manually delineated and tumor shape was analyzed by automatic computer algorithms Five features were automatically extracted from the images to quantify the extent of irregularity in tumor shape in two and three dimensions Univariate Cox proportional hazard regression analysis was performed to determine how prognostic each feature was of survival Kaplan Meier analysis was performed to illustrate the prognostic value of each feature To determine whether the proposed quantitative shape features have additional prognostic value compared with standard clinical features we controlled for tumor volume patient age and Karnofsky Performance Score KPS The FLAIRbased bounding ellipsoid volume ratio BEVR a 3D complexity measure was strongly prognostic of survival with a hazard ratio of 036 95 CI 020–065 and remained significant in regression analysis after controlling for other clinical factors P = 00061 Three enhancingtumor based shape features were prognostic of survival independently of clinical factors BEVR P = 00008 margin fluctuation P = 00013 and angular standard deviation P = 00078 Algorithmically assessed tumor shape is statistically significantly prognostic of survival for patients with GBM independently of patient age KPS and tumor volume This shows promise for extending the utility of MR imaging in treatment of GBM patientsThis material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No 1106401 Any opinions findings and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the view of the National Science Foundation
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