MR Imaging Grading System for Skull Base Chordoma

Tian, Kaibing; Wang, L.; Ma, Junpeng; Wang, K.; Li, D.; Du, Jiang; Jia, Guijun; Wu, Zhen; Zhang, J.

doi:10.3174/ajnr.a5152

Cited by 19 publications

(8 citation statements)

References 23 publications

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“…MR imaging is important not only for diagnosing and differentiating disease but also in predicting prognosis. 3,16,24 Among the 32 patients who did not undergo adjuvant radiation therapy in the present series, R EN and tumor blood supply were demonstrated as independent factors for PFS. Tian et al 16 and Lin et al 17 have also had similar results, which suggested that R EN was a risk factor for PFS.…”

Section: Discussionmentioning

confidence: 56%

“…14,15 Recent studies have suggested that MR imaging signal intensity ratios on different sequences (ratio of tumor-to-pons signal intensity on T1 FLAIR [R T1 ]; ratio of tumor-to-pons signal intensity on T2 [R T2 ]; ratio of tumor-to-pons signal intensity on enhanced T1 FLAIR [R EN ]) are useful in predicting outcomes. Tian et al 16 revealed that higher R T2 predicted diminished tumor progression and higher R EN predicted more rapid tumor progression; this correlation between R EN and recurrence or progression was also shown by Lin et al 17 However, neither of these studies showed evidence for the possible explanation of signal intensity difference.…”

mentioning

confidence: 81%

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MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

Bai

Shi

Zhang

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: MR imaging is a useful and widely used evaluation for chordomas. Prior studies have classified chordomas into cell-dense type and matrix-rich type according to the ultrastructural features. However, the relationship between the MR imaging signal intensity and ultrastructural classification is unknown. We hypothesized that MR imaging signal intensity may predict both tumor ultrastructural classification and prognosis.MATERIALS AND METHODS: Seventy-nine patients with skull base chordomas who underwent 95 operations were included in this retrospective single-center series. Preoperative tumor-to-pons MR imaging signal intensity ratios were calculated and designated as ratio on T1 FLAIR sequence (R T1 ), ratio on T2 sequence (R T2 ), and ratio on enhanced T1 FLAIR sequence (R EN ), respectively. We assessed the relationships among signal intensity ratios, ultrastructural classification, and survival. RESULTS:Compared with the matrix-rich type group, the cell-dense type chordomas showed lower R T2 (cell-dense type: 1.90 6 0.38; matrix-rich type: 2.61 6 0.60 P , .001). The model of predicting cell-dense type based on R T2 had an area under the curve of 0.83 (95% CI, 0.75-0.92). In patients without radiation therapy, both progression-free survival (P ¼ .003) and overall survival (P ¼ .002) were longer in the matrix-rich type group than in the cell-dense type group. R EN was a risk factor for progression-free survival (hazard ratio ¼ 10.24; 95% CI, 1.73-60.79); R T2 was a protective factor for overall survival (hazard ratio ¼ 0.33; 95% CI, 0.12-0.87); and R EN was a risk factor for overall survival (hazard ratio ¼ 4.76; 95% CI, 1.51-15.01). CONCLUSIONS:The difference in MR imaging signal intensity in chordomas can be explained by electron microscopic features. Both signal intensity ratios and electron microscopic features may be prognostic factors.

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Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 81%

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

Bai

Shi

Zhang

et al. 2020

AJNR Am J Neuroradiol

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“…[37][38][39][40] However, prior radiology literature addressing skull base chordomas has focused largely on identifying diagnostic imaging features, with only 1 recent study investigating the use of imaging as a prognostic tool. 36 In this study, we present findings suggesting that enhancement characteristics of skull base chordomas may be predictive of the clinical course.…”

mentioning

confidence: 71%

“…[33][34][35] While some studies have posited a correlation between MR imaging characteristics and histologic grade, analyses with larger samples have failed to demonstrate a statistically significant correlation between imaging features and chordoma histology. 33,34,36 Aside from its standard use as a diagnostic tool, MR imaging has demonstrated prognostic utility for many entities, with extensive literature supporting the use of signal intensity measurements in predicting prognosis for a variety of tumors. [37][38][39][40] However, prior radiology literature addressing skull base chordomas has focused largely on identifying diagnostic imaging features, with only 1 recent study investigating the use of imaging as a prognostic tool.…”

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confidence: 99%

Prognostic Implications of Gadolinium Enhancement of Skull Base Chordomas

Lin¹,

Scognamiglio

Yu³

et al. 2018

AJNR Am J Neuroradiol

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“…Recurrent patients have undergone previous combined treatments such as surgery and RT and both factors may explain why ceramides are significantly different in the two groups [25,31,32,33]. Since the recurrent tumor type and previous treatments represented a significant negative prognostic factor relating to worse OS and PFS in previous studies, a raising in ceramides content in SBCs could act as a negative prognostic factor [16,34,35,36]. We showed that there is also a concomitant rise in both ceramides and dihydroceramides and such a finding could be related to an activation of the de-novo pathway, but further analyses are needed.…”

Section: Discussionmentioning

confidence: 99%

Long and Very-Long-Chain Ceramides Correlate with A More Aggressive Behavior in Skull Base Chordoma Patients

Corte

Dei

Raggi

et al. 2019

IJMS

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Background: Skull base chordomas are rare tumors arising from notochord. Sphingolipids analysis is a promising approach in molecular oncology, and it has never been applied in chordomas. Our aim is to investigate chordoma behavior and the role of ceramides. Methods: Ceramides were extracted and evaluated by liquid chromatography and mass spectrometry in a cohort of patients with a skull base chordoma. Clinical data were also collected and correlated with ceramide levels. Linear regression and correlation analyses were conducted. Results: Analyzing the association between ceramides level and MIB-1, total ceramides and dihydroceramides showed a strong association (r = 0.7257 and r = 0.6733, respectively) with MIB-1 staining (p = 0.0033 and p = 0.0083, respectively). Among the single ceramide species, Cer C24:1 (r = 0.8814, p ≤ 0.0001), DHCer C24:1 (r = 0.8429, p = 0.0002) and DHCer C18:0 (r = 0.9426, p ≤ 0.0001) showed a significant correlation with MIB-1. Conclusion: Our lipid analysis showed ceramides to be promising tumoral biomarkers in skull base chordomas. Long- and very-long-chain ceramides, such as Cer C24:1 and DHCer C24:1, may be related to a prolonged tumor survival and aggressiveness, and the understanding of their effective biological role will hopefully shed light on the mechanisms of chordoma radio-resistance, tendency to recur, and use of agents targeting ceramide metabolism.

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MR Imaging Grading System for Skull Base Chordoma

Abstract: BACKGROUND AND PURPOSE: Skull base chordoma has been widely studied in recent years, however, imaging characteristics of this tumor have not been well elaborated. The purpose of this study was to establish an MR imaging grading system for skull base chordoma.

Cited by 19 publications

References 23 publications

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

Prognostic Implications of Gadolinium Enhancement of Skull Base Chordomas

Long and Very-Long-Chain Ceramides Correlate with A More Aggressive Behavior in Skull Base Chordoma Patients

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