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Magnetic resonance imaging signal characteristics associated with prognosis of skull base chordoma after gamma knife radiosurgery

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Abstract

Objective

To investigate the association between the magnetic resonance imaging (MRI) signal characteristics of skull base chordoma and radiosurgical outcomes.

Methods

Twenty-four patients with skull base chordomas treated with Gamma Knife radiosurgery (GKRS) after previous surgical resection were retrospectively (2001–2021) examined. Pre-GKRS MRIs were analyzed for RT2 (tumor-to-brainstem signal intensity ratio on T2-weighted imaging), RCE (tumor-to-brainstem signal intensity ratio on contrast-enhanced T1-weighted imaging), and mean apparent diffusion coefficient (ADC). Correlations of the parameters with patient survival and local tumor progression were made by using Cox regression and Kaplan–Meier analyses.

Results

During a median follow-up of 46 months after GKRS, 9 patients died with significantly more local tumor progression events (median number: 2 vs 0, P = .012) than did 15 alive patients. On multivariable analysis, higher mean ADC was associated with longer patient survival (P = .016) after GKRS. The actuarial 5-year overall survival rates were 88.9% versus 54.7% for chordomas with an ADC of ≥ 1270 × 10–6 mm2/s versus < 1270 × 10–6 mm2/s. RT2 < 1.5 (P = .038) and RCE > 1.57 (P = .022) were associated with a lower probability of local tumor control.

Conclusion

Lower mean ADC values are associated with shorter patient survival in skull base chordomas after GKRS. Diffusion-weighted imaging may help in GKRS planning and outcome prediction for these patients.

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Data availability

The datasets generated during the current study are not publicly available due to information that could compromise the privacy of research participants, but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Hsin-Yi Huang (Biostatistics Task Force, Taipei Veterans General Hospital) for providing statistical analysis assistance.

Funding

This work was supported by Taipei Veterans General Hospital (Grant Number: V110C-056) and Taiwan’s Ministry of Science and Technology (Grant Number: MOST-109-2628-B-010-014-MY2).

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Authors and Affiliations

  1. Department of Radiology, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan

    Yong-Sin Hu

  2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yong-Sin Hu, Cheng-Chia Lee, Chia-An Wu, Chung-Jung Lin, Huai-Che Yang, Wan-Yuo Guo, Kang-Du Liu, Wen-Yuh Chung, Cheng-Ying Shiau & Hsiu-Mei Wu

  3. Department of Radiology, Taipei Veterans General Hospital, No. 201, Shipai Rd., Sec. 2, Beitou District, Taipei, 112, Taiwan

    Yong-Sin Hu, Chia-An Wu, Chung-Jung Lin, Wan-Yuo Guo & Hsiu-Mei Wu

  4. Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Cheng-Chia Lee, Huai-Che Yang, Kang-Du Liu & Wen-Yuh Chung

  5. Department of Radiology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Chia-An Wu

  6. Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Wen-Yuh Chung

  7. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan

    Cheng-Ying Shiau

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  1. Yong-Sin Hu
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  10. Hsiu-Mei Wu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Y-SH, C-CL and C-AW. The first draft of the manuscript was written by Y-SH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hsiu-Mei Wu.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Taipei Veterans General Hospital (2021–07-025CC).

Consent to participate

The Taipei Veterans General Hospital institutional review board approved the study protocol and waived the need for consent.

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Hu, YS., Lee, CC., Wu, CA. et al. Magnetic resonance imaging signal characteristics associated with prognosis of skull base chordoma after gamma knife radiosurgery. J Neurooncol 161, 45–56 (2023). https://doi.org/10.1007/s11060-022-04199-x

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  • DOI: https://doi.org/10.1007/s11060-022-04199-x

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