Correlation of morphologic findings and apparent diffusion coefficient values with Ki-67 proliferation index in patients with glioblastoma

Yıl 2022, Cilt: 8 Sayı: 6, 790 - 799, 04.11.2022

Süleyman Öncü , İsmail Şerifoğlu , Fatma Zeynep Arslan , Mehmet Karagülle , Samet Şimşek , Gül Gizem Kaya , Ahmet Tan Cimilli

https://doi.org/10.18621/eurj.1033999

Cited By: 1

Öz

Objectives: Glioblastoma is the most common primary neoplasm of the central nervous system (CNS) and has a very poor prognosis. Ki-67 proliferative index is a value that reflects the mitotic index of the tumor and is associated with poor prognosis. The radiological features of the tumors can predict the course of the disease. The aim of this study is to evaluate the relationship between the morphology and the apparent diffusion coefficient (ADC) values of the tumor with the Ki-67 index on preoperative magnetic resonance imaging (MRI).

Methods: Preoperative MRI images of 52 patients with pathological diagnosis of glioblastoma were evaluated retrospectively. A score ranging from 1 to 3 was assigned to each of the morphological features of the tumors (peritumoral edema, necrosis, contrasting pattern, heterogeneity, hemorrhage, mass effect, tumor contour irregularity), and was added up to obtain the total score. In addition, the ADC values of each tumor were measured at the workstation. ADC value and total score of each tumor, and Ki-67 values obtained histopathologically were compared.

Results: There was a negative correlation between Ki-67 index of tumors and ADC values (r=-0.895, p = 0.0001). A significant positive correlation was found between the morphological features of the tumors and their total scores (r=0.772, p = 0.0001). A statistically significant negative correlation was found between total score and ADC values (r=-0.780, p = 0.0001). Heterogeneity and necrosis were the features most closely associated with Ki-67. These were followed by mass effect, hemorrhage and contour irregularity, respectively.

Conclusions: The morphological findings and ADC values obtained from preoperative MRI are related to the Ki-67 value, and thus can be used to predict prognosis and guide treatment in the early period.

Anahtar Kelimeler

Glioblastoma, Ki-67, magnetic resonance imaging, prognosis

Kaynakça

• 1. Walker MD, Green SB, Byar DP, Alexander E Jr, Batzdorf U, Brooks WH, et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 1980;303:1323-9.
• 2. Shapiro WR, Green SB, Burger PC, Mahaley MS Jr, Selker RG, VanGilder JC, et al. Randomized trial of three chemotherapy regimens and two radiotherapy regimens and two radiotherapy regimens in postoperative treatment of malignant glioma. Brain Tumor Cooperative Group Trial 8001. J Neurosurg 1989;71:1-9.
• 3. Hammoud MA, Sawaya R, Shi W, Thall PF, Leeds NE. Prognostic significance of preoperative MRI scans in glioblastoma multiforme. J Neurooncol 1996;27:65-73.
• 4. Fine HA. The basis for current treatment recommendations for malignant gliomas. J Neurooncol 1994;20:111-20.
• 5. Gerdes J, Schwab U, Lemke H, Stein H. Production of a mouse monoclonal antibody reactive with a human nuclear antigen associated with cell proliferation. Int J Cancer 1983;15:13-20.
• 6. Torp SH. Diagnostic and prognostic role of Ki67 immunostaining in human astrocytomas using four different antibodies. Clin Neuropathol 2002;21:252-7.
• 7. Glantz MJ, Burger PC, Herndon JE 2nd, Friedman AH, Cairncross JG, Vick NA. Influence of the type of surgery on the histologic diagnosis in patients with anaplastic gliomas. Neurology 1991;41:1741-4.
• 8. Pierallini A, Bonamini M, Osti MF, Pantano P, Palmeggiani F, Santoro A, et al. Supratentorial glioblastoma: neuroradiological findings and survival after surgery and radiotherapy. Neuroradiology 1996;38:26-30.
• 9. Shukla G, Alexander GS, Bakas S, Nikam R, Talekar K, Palmer JD, et al. Advanced magnetic resonance imaging in glioblastoma: a review. Chin Clin Oncol 2017;6:40.
• 10. Kim JY, Park JE, Jo Y, Shim WH, Nam SJ, Kim JH, et al. Incorporating diffusion- and perfusion-weighted MRI into a radiomics model improves diagnostic performance for pseudoprogression in glioblastoma patients. Neuro Oncol 2019;21:404-14.
• 11. Suh CH, Kim HS, Jung SC, Choi CG, Kim SJ. Multiparametric MRI as a potential surrogate endpoint for decision-making in early treatment response following concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma: a systematic review and meta-analysis. Eur Radiol 2018;28:2628-38.
• 12. Rees JH, Smirniotopoulos JG, Jones RV, Wong K. Glioblastoma multiforme: radiologic-pathologic correlation. Radiographics 1996;16:1413-38.
• 13. Torp SH. Diagnostic and prognostic role of Ki67 immunostaining in human astrocytomas using four different antibodies. Clin Neuropathol 2002;21:252-7.
• 14. Wakimoto H, Aoyagi M, Nakayama T, Nagashima G, Yamamoto S, Tamaki M, et al. Prognostic significance of Ki-67 labeling indices obtained using MIB-1 monoclonal antibody in patients with supratentorial astrocytomas. Cancer 1996;77:373-80.
• 15. Montine TJ, Vandersteenhoven JJ, Aguzzi A, Boyko OB, Dodge RK, et al. Prognostic significance of Ki-67 proliferation index in supratentorial fibrillary astrocytic neoplasms. Neurosurgery 1994;34:674-8.
• 16. Sallinen PK, Haapasalo HK, Visakorpi T, Helén PT, Rantala IS, Isola JJ. Prognostication of astrocytoma patient survival by Ki-67 (MIB-1), PCNA, and S-phase fraction using archival paraffin-embedded samples. J Pathol 1994;174:275-82.
• 17. Reavey-Cantwell JF, Haroun RI, Zahurak M, Clatterbuck RE, Parker RJ, Mehta R, et al. The prognostic value of tumor markers in patients with glioblastoma multiforme: analysis of 32 patients and review of the literature. J Neurooncol 2001;55:195-204.
• 18. Pierallini A, Bonamini M, Bozzao A, Pantano P, Stefano DD, Ferone E, et al. Supratentorial diffuse astrocytic tumours: proposal of an MRI classification. Eur Radiol 1997;7:395-9.
• 19. Dean BL, Drayer BP, Bird CR, Flom RA, Hodak JA, Coons SW, et al. Gliomas: classification with MR imaging. Radiology 1990;174:411-5.
• 20. Asari S, Makabe T, Katayama S, Itoh T, Tsuchida S, Ohmoto T. Assessment of the pathological grade of astrocytic gliomas using an MRI score. Neuroradiology 1994;36:308-10.
• 21. Shahmohammadi M, Fazeli MA, Janamiri Z, Gorji RA. Correlation of ADC map with the Ki-67 index in glial tumor prognosis in patients of stereotaxic ward. Int Clin Neurosci J 2017;4:18-24.
• 22. Calvar JA, Meli FJ, Romero C, Calcagno ML, Yánez P, Martinez AR, et al. Characterization of brain tumors by MRS, DWI and Ki-67 labeling index. J Neurooncol 2005;72:273-80.
• 23. Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, et al. Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology 2006;241:839-46.
• 24. Oh J, Henry RG, Pirzkall A, Lu Y, Li X, Catalaa I, et al. Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume. J Magn Reson Imaging 2004;19:546-54.
• 25. Segall HD, Destian S, Nelson MD, Zee CS, Ahmadi J. CT and MR imaging in malignant gliomas. In: Apuzzo MLJ (ed). Malignant Cerebral Glioma. AANS, Illinois, 1990: pp. 63-77.
• 26. Hasse A, Dapash M, Jeong Y, Ansari SA, Carroll TJ, Lesniak M, et al. Correlation of post-contrast T1-weighted MRI surface regularity, tumor bulk, and necrotic volume with Ki67 and p53 in glioblastomas. Neuroradiology 2019;61:861-7.
• 27. Hammoud MA, Sawaya R, Shi W, Thall PF, Leeds NE. Prognostic significance of preoperative MRI scans in glioblastoma multiforme. J Neurooncol 1996;27:65-73.
• 28. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001;95:190-8.
• 29. Steed TC, Treiber JM, Brandel MG, Patel KS, Dale AM, Carter BS, et al. Quantification of glioblastoma mass effect by lateral ventricle displacement. Sci Rep 2018;8:2827.
• 30. Park JK, Hodges T, Arko L, Shen M, Dello Iacono D, et al. Scale to predict survival after surgery for recurrent glioblastoma multiforme. J Clin Oncol 2010;28:3838-43.
• 31. Gamburg ES, Regine WF, Patchell RA, Strottmann JM, Mohiuddin M, Young AB. The prognostic significance of midline shift at presentation on survival in patients with glioblastoma multiforme. Int J Radiat Oncol Biol Phys 20001;48:1359-62.
• 32. Kreth FW, Berlis A, Spiropoulou V, Faist M, Scheremet R, Rossner R, et al. The role of tumor resection in the treatment of glioblastoma multiforme in adults. Cancer 1999;86:2117-23.
• 33. Front D, Israel O, Kohn S, Nir I. The blood-tissue barrier of human brain tumors: correlation of scintigraphic and ultrastructural findings: concise communication. J Nucl Med 1984;25:461-5.
• 34. Sage MR. Blood-brain barrier: phenomenon of increasing importance to the imaging clinician. AJR Am J Roentgenol 1982;138:887-98.
• 35. Earnest F, Kelly PJ, Scheithauer BW, Kall BA, Cascino TL, Ehman RL, et al. Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy. Radiology 1988;166:823-7.
• 36. Tervonen O, Forbes G, Scheithauer BW, Dietz MJ. Diffuse "fibrillary" astrocytomas: correlation of MRI features with histopathologic parameters and tumor grade. Neuroradiology 1992;34:173-8.
• 37. Pérez-Beteta J, Molina-García D, Ortiz-Alhambra JA, Fernández-Romero A, Luque B, Arregui E, et al. Tumor surface regularity at MR imaging predicts survival and response to surgery in patients with glioblastoma. Radiology 2018;288:218-25.
• 38. Cui Y, Tha KK, Terasaka S, Yamaguchi S, Wang J, Kudo K, et al. Prognostic imaging biomarkers in glioblastoma: development and independent validation on the basis of multiregion and quantitative analysis of MR images. Radiology 2016;278:546-53.
• 39. Modic MT, Beale SM. Magnetic resonance imaging of supratentorial neoplasms. Neurosurgery, Update I. New York, McGraw-Hill Book Co, 1990; 12-29.
• 40. Bydder GM, Steiner RE, Thomas DJ, Marshall J, Gilderdale DJ, Young IR. Nuclear magnetic resonance imaging of the posterior fossa: 50 cases. Clin Radiol 1983;34:173-88.
• 41. Levin VA, Hoffman WF, Heilbron DC, Norman D. Prognostic significance of the pretreatment CT scan on time to progression for patients with malignant gliomas. J Neurosurg 1980;52:642-7.
• 42. Taillandier L, Bracard S, Anxionnat R, Debouverie M, Baylac F, Duprez A, et al. Neuroradiological prognostic factors of adult supratentorial astrocytoma. Neuroradiology 1994;36 (Suppl 1):S50.
• 43. Watanabe K, Wakai S, Okuhata S. Gliomas presenting with basal ganglionic haemorrhage. Report of two cases. Acta Neurochir (Wien) 1997;139:787-8.
• 44. McGahan BG, Neilsen BK, Kelly DL, McComb RD, Kazmi SA, White ML, et al. Assessment of vascularity in glioblastoma and its implications on patient outcomes. J Neurooncol 2017;132:35-44.