Lipid Fraction Derived From MRI In- and Opposed-Phase Sequence as a Novel Biomarker for Predicting Survival Outcome of Glioma

Pohchoo Seow; Vairavan Narayanan; Ronie J Romelean; Jeannie Hsiu Ding Wong; Myint Tun Win; Hari Chandran; Karuthan Chinna; Kartini Rahmat; Norlisah Ramli

doi:10.1016/j.acra.2019.04.015

Lipid Fraction Derived From MRI In- and Opposed-Phase Sequence as a Novel Biomarker for Predicting Survival Outcome of Glioma

Acad Radiol. 2020 Feb;27(2):180-187. doi: 10.1016/j.acra.2019.04.015. Epub 2019 May 31.

Authors

Pohchoo Seow¹, Vairavan Narayanan², Ronie J Romelean², Jeannie Hsiu Ding Wong¹, Myint Tun Win³, Hari Chandran², Karuthan Chinna⁴, Kartini Rahmat¹, Norlisah Ramli⁵

Affiliations

¹ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur 50603, Malaysia; Faculty of Medicine, University of Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia.
² Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
³ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur 50603, Malaysia.
⁴ School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Malaysia.
⁵ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur 50603, Malaysia; Faculty of Medicine, University of Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: norlisahramli@gmail.com.

PMID: 31155487
DOI: 10.1016/j.acra.2019.04.015

Abstract

Rationale and purpose: Our study evaluated the capability of magnetic resonance imaging in- and opposed-phase (IOP) derived lipid fraction as a novel prognostic biomarker of survival outcome in glioma.

Materials and methods: We analyzed 46 histologically proven glioma (WHO grades II-IV) patients using standard 3T magnetic resonance imaging brain tumor protocol and IOP sequence. Lipid fraction was derived from the IOP sequence signal-loss ratio. The lipid fraction of solid nonenhancing region of glioma was analyzed, using a three-group analysis approach based on volume under surface of receiver-operating characteristics to stratify the prognostic factors into three groups of low, medium, and high lipid fraction. The survival outcome was evaluated, using Kaplan-Meier survival analysis and Cox regression model.

Results: Significant differences were seen between the three groups (low, medium, and high lipid fraction groups) stratified by the optimal cut-off point for overall survival (OS) (p ≤ 0.01) and time to progression (p ≤ 0.01) for solid nonenhancing region. The group with high lipid fraction had five times higher risk of poor survival and earlier time to progression compared to the low lipid fraction group. The OS plot stratified by lipid fraction also had a strong correlation with OS plot stratified by WHO grade (R = 0.61, p < 0.01), implying association to underlying histopathological changes.

Conclusion: The lipid fraction of solid nonenhancing region showed potential for prognostication of glioma. This method will be a useful adjunct in imaging protocol for treatment stratification and as a prognostic tool in glioma patients.

Keywords: Gliomas; In- and opposed-phase sequence (IOP); Lipid fraction; Lipid quantification; Magnetic resonance spectroscopy (MRS); Stratification; Survival study; Three-group VUS analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers*
Biomarkers, Tumor / analysis*
Brain Neoplasms* / diagnostic imaging
Glioma* / diagnostic imaging
Humans
Lipids* / analysis
Magnetic Resonance Imaging
Prognosis

Substances

Biomarkers
Biomarkers, Tumor
Lipids