The value of multimodal magnetic resonance functional imaging in the diagnosis of postoperative glioma recurrence and its implications for radiotherapy

QIAN Liping; ZHANG Yuming; CHEN Huafang; JIN Chengyu; MAO Lihua; ZHOU Jian

Abstract：Objective To investigate the value of multimodal magnetic resonance functional imaging in diagnosing postopera-tive recurrence of glioma and guiding radiotherapy.Methods The clinical data of 60 patients with glioma who underwent post-operative radiotherapy in our hospital were selected.General information,cerebrospinal fluid exocytosis recurrence-related mark-ers[microRNA-146a(miR-146a),microRNA-424(miR-424)],multimodal fMRI parameters[standardized cerebral blood vol-ume(CBVnorm),ADC,metabolite choline(Cho)to creatine/phosphocreatine(Cr)ratio(Cho/Cr),and Cho to N-acetylaspartate(NAA)ratio(Cho/NAA)]were compared.The correlation of multimodal fMRI parameters with cerebrospinal fluid exosomes miR-146a and miR-424 in patients with glioma,as well as the value of diagnosing postoperative recurrence of glioma were analyzed.Results The mean CBVnorm,maximum CBVnorm,Cho/Cr,Cho/NAA and cerebrospinal fluid exosome miR-424 relative expressions were higher in the recurrence group than in the PsP group,and the ADC and cerebrospinal fluid exosome miR-146a relative expressions were lower than those in the PsP group(P<0.05);the mean postoperative magnetic resonance functional imaging parameters in patients with glioma CBVnorm,maximal CBVnorm,Cho/Cr,and Cho/NAA were nega-tively correlated with the relative expression of cerebrospinal fluid exosome miR-146a and positively correlated with miR-424,and ADC was positively correlated with the relative expression of miR-146a and negatively correlated with miR-424(P<0.05).The area under the curve(AUC)for the diagnosis of postoperative recurrence of glioma for mean CBVnorm,maximum CBVnorm,ADC,Cho/Cr,Cho/NAA,cerebrospinal fluid exosome miR-146a,and miR-424 relative expression was 0.733,0.829,0.749,0.779,0.810,0.719,and 0.707,respectively,and the maximum AUC for the combined diagnosis of mean CBVnorm,maximum CBVnorm,ADC,Cho/Cr,and Cho/NAA for postoperative recurrence was 0.932(95%CI 0.837-0.981),with diagnostic sensi-tivity and specificity of 90.00%and 90.00%,respectively.Conclusion Multimodal magnetic resonance functional imaging has reliable diagnostic efficacy in the differential diagnosis of postoperative glioma recurrence and PsP,which can guide the develop-ment of clinical postoperative radiotherapy regimens for glioma.