Is Edema Zone Volume Associated With Ki-67 Index in Glioblastoma Patients?

Abstract

IntroductionDespite all the progress with genetic mapping and multimodal treatment, the prognosis of Glioblastoma multiforme (GBM) remains poor, with median overall survival (OS) of only 12 to 15 months. Several studies showed correlations between glioblastoma clinic and prognosis factors; however, it doesn`t occur with tumor radiological features. The purpose of this study is to determine possible correlations between the volumetric analysis of glioblastoma compartments and the proliferation index represented by Ki-67. MethodsWe performed a retrospective analysis of MRI studies of 70 patients with glioblastoma multiforme acquired up to one week before surgery. The tumor compartments were divided into enhancing zone; edema zone and tumor total zone. Each compartment was submitted to volumetric analysis using Horos Project software. A linear regression model was used to assess correlations between the ki-67 index and the volume of each compartment with a p-value of 0.05. ResultsThe male/female ratio in our study was 1.7:1, at a mean age of 60.7 ± 14.6 years. Tumor predominant location was the temporal lobe with 25% of cases and cystic morphology was present in 17%. The median of Ki-67 was 40%. The average tumor compartment volume was 40 cm 3 for the contrast-enhancing zone, 62 cm 3 for the edema zone, and 103 cm 3 for the total tumor volume. A significant association between the Ki-67 index and edema zone volume (p=0.02) was found. ConclusionVolumetric analysis of the glioblastoma edema zone by MRI allows for predicting tumor aggressiveness through correlation with the Ki-67 index.

Reduced volume intensity-modulated radiotherapy with simultaneous integrated boost for patients with high-grade glioma: A retrospective observational study

“…[24][25][26][27] In a study conducted by Caramanti et al, Ki-67 index was identified as an indicator of tumor aggressiveness, which correlated with the volume of peritumoral edema. [28] In this study, we confirmed that a high Ki-67 index (>27.4%) is a risk factor for recurrence in patients with high-grade gliomas who underwent rvSIB-IMRT. Further research is needed to determine whether an increase in the margin or dose of RT can improve therapeutic outcomes in these patients who has risk factors treated with rvSIB-IMRT.…”

Advancements in Image-Based Models for High-Grade Gliomas Might Be Accelerated

“…MRI studies of 70 patients with GB acquired up to one week before surgery. [123] Elevated prognostic capacity of imaging-based risk stratification in patients with diffuse glioma, NOS. 220 patients classified as diffuse glioma, NOS.…”

“…Caramanti and collaborators found a correlation between the volume of tumorinduced oedema measured by MRI and the Ki-67 proliferation index. According to this study, the two parameters might be considered in relation to each other and be prognostic of OS [123] (Figure 13G,H) (Table 2). A preoperative T2-weighted MRI-based radiomics model was developed by Li and collaborators as a survival prognostic tool for HGG patients [118] (Figure 13B-D) (Table 2).…”

“…MRI in FLAIR-weighted sequence showing the calculation of the lesion volume for the tumor edema zone. Volumetric calculations were estimated by measuring the area of interest with a slice-by-slice semi-automatic method (after[117,118,120,122,123] with permission).…”