The Prognostic Value Of Magnetic Resonance Imaging Characteristics Within Peritumoral Edema In High-grade Gliomas

Objective:Peritumoral edema(PTE)was one of the main characteristics of high-grade gliomas.We evaluated its prognostic value for progression-free survival(PFS)based on magnetic resonance imaging(MRI),combined with clinical baseline data and histopathological data.Materials and methods:Forty-one patients with high-grade glioma confirmed by pathology were enrolled in this study.The male: female ratio was 21:20.In addition,the PFS was assessed based on the Response Assessment in Neuro-Oncology(RANO)criterion and documented for each patient.We analyzed the potential prognostic factors of PTE obtained from MRI combined with the clinical baseline data and histopathology data.The best cut-off value of each potential prognostic factor for Kaplan-Meier survival estimates was calculated by X-tile software.Kaplan-Meier survival estimates and log-rank test were used to characterize and compare the patient groups with different level of potential factors in terms of PFS.Cox proportional hazard analysis was used to assess the relationship between PFS and factors which have significantly different survival time.Results:(1)The med PFS for all patients was 174.00 days.The best cut-off value of tumor size(cm),radius of PTE(cm),N-r ADC,D-r ADC,r ADCmean,r ADCmin for Kaplan-Meier univariable analysis was 3.4,1.7,2.2,2.0,2.2,1.4 respectively.(2)Kaplan-Meier univariable analysis revealed several variables including age,radius of PTE,N-r ADC,r ADCmin were significantly associated with PFS.Patients whose age(years)were greater than 50 had a shorter PFS compared with patients whose age(years)were equal or less than 50(P=0.030).Patients with a radius of PTE(cm)greater than1.7 also showed a shorter PFS than which not(P=0.007).Moreover,PFS was found to be statistically longer in patients either with a N-r ADC that greater than 2.2(P=0.022)or with a r ADCmin greater than 1.4(P=0.041).Whereas,other potential factors we evaluated,for instance gender and tumour grade,showed no statistic significance for analyzing PFS(P>0.05).(3)Multivariable analysis using Cox proportional hazard indicated age(HR:2.29,P:0.023),radius of PTE(HR:3.69,P:0.002),and r ADCmin(HR:0.28,P:0.002)but not N-r ADC(P>0.05)were independent prognostic factor of PFS.Conclusion:(1)Patients with age(years)>50 or radius of PTE(cm)>1.7 or N-r ADC ?2.2 or r ADCmin ? 1.4 had a unfavorable outcomes and showed a shorter PFS.(2)Age,radius of PTE,r ADCmin but not N-r ADC were independent prognostic factor for high-grade gliomas.(3)Assessment of the MRI characteristics of PTE can provide marked values in treatment decision and postoperative management for patients with high-grade gliomas.