Magnetic resonance imaging signal characteristics associated with prognosis of skull base chordoma after gamma knife radiosurgery.
J Neurooncol
; 161(1): 45-56, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-36565364
ABSTRACT
OBJECTIVE:
To investigate the association between the magnetic resonance imaging (MRI) signal characteristics of skull base chordoma and radiosurgical outcomes.METHODS:
Twenty-four patients with skull base chordomas treated with Gamma Knife radiosurgery (GKRS) after previous surgical resection were retrospectively (2001-2021) examined. Pre-GKRS MRIs were analyzed for RT2 (tumor-to-brainstem signal intensity ratio on T2-weighted imaging), RCE (tumor-to-brainstem signal intensity ratio on contrast-enhanced T1-weighted imaging), and mean apparent diffusion coefficient (ADC). Correlations of the parameters with patient survival and local tumor progression were made by using Cox regression and Kaplan-Meier analyses.RESULTS:
During a median follow-up of 46 months after GKRS, 9 patients died with significantly more local tumor progression events (median number 2 vs 0, P = .012) than did 15 alive patients. On multivariable analysis, higher mean ADC was associated with longer patient survival (P = .016) after GKRS. The actuarial 5-year overall survival rates were 88.9% versus 54.7% for chordomas with an ADC of ≥ 1270 × 10-6 mm2/s versus < 1270 × 10-6 mm2/s. RT2 < 1.5 (P = .038) and RCE > 1.57 (P = .022) were associated with a lower probability of local tumor control.CONCLUSION:
Lower mean ADC values are associated with shorter patient survival in skull base chordomas after GKRS. Diffusion-weighted imaging may help in GKRS planning and outcome prediction for these patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Cordoma
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Radiocirurgia
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Neoplasias da Base do Crânio
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Neoplasias de Cabeça e Pescoço
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article