Predicting survival of children with CNS tumors using proton magnetic resonance spectroscopic imaging biomarkers

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dc.contributor.authorMarcus, K. J.en
dc.contributor.authorAstrakas, L. G.en
dc.contributor.authorZurakowski, D.en
dc.contributor.authorZarifi, M. K.en
dc.contributor.authorMintzopoulos, D.en
dc.contributor.authorPoussaint, T. Y.en
dc.contributor.authorAnthony, D. C.en
dc.contributor.authorDe Girolami, U.en
dc.contributor.authorBlack, P. M.en
dc.contributor.authorTarbell, N. J.en
dc.contributor.authorTzika, A. A.en
dc.date.accessioned2015-11-24T18:57:23Z
dc.date.available2015-11-24T18:57:23Z
dc.identifier.issn1019-6439-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/19164
dc.rightsDefault Licence-
dc.subjectAdolescenten
dc.subjectAlgorithmsen
dc.subjectBrain Neoplasms/*mortality/pathologyen
dc.subjectCentral Nervous System Neoplasms/*mortality/pathologyen
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectInfanten
dc.subjectMagnetic Resonance Spectroscopy/*methodsen
dc.subjectMaleen
dc.subjectProportional Hazards Modelsen
dc.subjectProtonsen
dc.subjectRegression Analysisen
dc.subjectTreatment Outcomeen
dc.subjectTumor Markers, Biological/*metabolismen
dc.titlePredicting survival of children with CNS tumors using proton magnetic resonance spectroscopic imaging biomarkersen
heal.abstractUsing brain proton magnetic resonance spectroscopic imaging (MRSI) in children with central nervous system (CNS) tumors, we tested the hypothesis that combining information from biologically important metabolites, at diagnosis and prior to treatment, would improve prediction of survival. We evaluated brain proton MRSI exams in 76 children (median age at diagnosis: 74 months) with brain tumors. Important biomarkers, choline-containing compounds (Cho), N-acetylaspartate (NAA), total creatine (tCr), lipids and/or lactate (L), were measured at the "highest Cho region" and normalized to the tCr of surrounding healthy tissue. Neuropathological grading was performed using World Health Organization (WHO) criteria. Fifty-eight of 76 (76%) patients were alive at the end of the study period. The mean survival time for all subjects was 52 months. Univariate analysis demonstrated that Cho, L, Cho/NAA and tumor grade differed significantly between survivors and non-survivors (P< or =0.05). Multiple logistic regression and stepwise multivariate Cox regression indicated that Cho + 0.1L was the only independent predictor of survival (likelihood ratio test = 10.27, P<0.001; Cox regression, P=0.004). The combined index Cho + 0.1L was more accurate and more specific predictor than Cho or Cho/NAA. Accuracy and specificity for Cho + 0.1L were 80% and 86%, respectively. We conclude that brain proton MRSI biomarkers predict survival of children with CNS tumors better than does standard histopathology. More accurate prediction using this non-invasive technique represents an important advance and may suggest more appropriate therapy, especially when diagnostic biopsy is not feasible.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/17273766-
heal.journalNameInt J Oncolen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2007-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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