Pre- and post-surgery MRSI predictive value in adult oligodendroglioma prognosis

Abstract : Purpose: The aim of this study was to study the relationship between MRSI, before and after surgery, and patient survival. The accuracy of pre-operative MRSI in differentiating low-from high-grade oligodendrogliomas (ODGs) was also studied. Methods: Two hundred patients with ODG were retrospectively included in this study between 2000 and 2016. All patients underwent MRSI before any treatment or biopsy and/or after surgery for an intra-axial brain tumour. The R software was used for statistical data analysis. p < 0.05 was considered statistically significant. Kaplan-Meier curves were calculated for patients with low-grade ODG and high-grade ODG pre-and post-operatively, to study survival (overall survival, OS). The best threshold of each MRSI metabolite ratio was obtained using receiver operating characteristic curves (ROCs). Results: One hundred patients underwent pre-operative MRSI and 170 post-operative MRSI. N-acetylaspartate (NAA), lactate (Lac), choline (Cho) and creatine (Cr) were measured. Kapan-Meier curves showed that survival was poorer for a nCho/Cr > 3.02 in the pre-operative and nCho/Cr > 2.04, Lac/Cr > 0.743 and nCho/ NAA > 3.63 in the post-operative period. Post-operative MRSI predicts survival better than pre-operative MRSI. nCho/Cr and Lac/Cr distinguished low-from high-grade ODG with a good positive predictive value. Conclusion: MRSI is associated with survival. It is a non-invasive tool which completes histopathology and can predict patients' prognosis, thus improving patient management.
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Caroline Bund, François Lefebvre, Roland Schott, Marie-Pierre Chenard, Benoit Lhermitte, et al.. Pre- and post-surgery MRSI predictive value in adult oligodendroglioma prognosis. Magnetic Resonance Imaging, Elsevier, 2018, 52, pp.75-83. ⟨10.1016/j.mri.2018.06.007⟩. ⟨inserm-02089247⟩

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