Preliminary Study On Quantitative T2-FLAIR Evaluation Of High Grade Glioma After Treatment

Part oneThe value of increased extremum of FLAIR singal within the recection cavity of high-grade gliomas after surgery for detection progression and survivalObjective:The aim of this study was to assess increased extremum of FLAIR signal within the recection cavity in postoperative HGG cohort to assess the value of early tumor progression and survival in HGG patients.Metholds:A total of 49 HGG petients who undergone total recection and standardized treatment of NCCN were included in the retrospective study.Increased extremum,maximum,minimum and median of FLAIR signal in recection cavity was obtain by measuring relative FLAIR signal value(FLAIR signal in recection cavity/FLAIR signal in ventricle).Receiver operatingcharacteristic(ROC)wasusingtoanalyzeincreased extremum,maximum,minimum and median of FLAIR signal in recection cavity the efficiency for progression in postoperative HGG petients,and progression free survival(PFS)and overall survival(OS)of high increased extramum group was compared with low increased extremum group.Single factor and multiple factor logistic regression curve was to analyse which parameter can predict progression.Results:Both increased extremum and maximum of FLAIR signal can predicttumorprogression(Pvalueswere0.014and0.045,respectively),whereas diagnostic efficiency of increased extramum is better than maximum[area under curve(AUC)0.707>0.668],sensitivity and specificity were 61%and 91%,respectively.The cut-off value of increased extremum for predicting progression is 5.448.PFS and OS between high and low increased extremum groups is different significantly,PFS(405.2d:234.7d,P=0.001),OS(497.3±28.0:367.6±33.2,P=0.008).Increased extremum,maxim-um,median of FLAIR signal in recection cavity and sex were all can predict progression,whereas only increased extremum is independent±predictor(P=0.001).Conclusion:Increased extremum of FLAIR signal within the recection cavity in postoperative HGG cohort is statistical significance for suvival,high increased extremum maybe independent predictor of poor prognosis,which suggest that increased extremum of FLAIR signal within the recection cavity in post-therapy HGG patients maybe have promotion value.Part twoExplore the value of FLAIR area growth rate at the largest level in high-grade gliomas with treatment in the assessment of progression and survivalObjective:High-grade glioma(HGG)is the most common malignant brain tumor with poor prognosis,FLAIR enlargement plays an important role for detection of progression.The aim of this study was to analyse FLAIR growth rate in postoperative HGG cohort to assess the value of early tumor progression and survival in HGG patients.Metholds:A total of 49 HGG petients who undergone total recection and standardized treatment of NCCN were included in the retrospective study.FLAIR volume and area at the largest level were recored at 3months after surgery and at progression/at the last follow-up without progression for the FLAIR volume growth rate and area growth rate at the largest level.Receiver operating characteristic(ROC)curve was using to analyze the diagnositic efficiency of FLAIR volume growth rate and area growth rate at the largest level for progression in postoperative HGG petients,and progression free survival(PFS)and overall survival(OS)of high FLAIR growth rate group was compared with low FLAIR growth rate group.Results:Both FLAIR volume growth rate and area growth rate at the largest level could detect progression(P<0.001),with the same diagnostic efficiency(area under curve(AUC)was 0.921,0.906,respectively),the positive predictive value(PPV)and negative predictive values(NPV)were(82.6%,88.2%),(90.5%,82.4%),respectively.detect progression The cut-off value of FLAIR volume growth rate and area growth rate at the largest level for predicting progression were 2.1ml/mon,0.51cm~2/mon,respectively.PFS and OS between fast and slow FLAIR volume growth rate groups were different significantly,PFS(405.2d:234.7d,P<0.001),OS(497.3±28.0:367.6±33.2,P=0.008),and the same with area growth rate between fast and slow groups,PFS(215.3±19.3d:417.6±36.1d,P<0.001),OS(390.5±36.6d:548.0±49.3d,P=0.045).Conclusion:Both FLAIR volume growth rate and area growth rate at the largest level are helpful to detect progression with the same efficiency,while using area is simpler.