Date of Award
Medical Doctor (MD)
Aims: Given increasing interest in laser interstitial thermotherapy to treat brain tumor
patients, we explored if examining multiple MRI contrasts per laser patient can impact
predictive accuracy of survival post-LITT.
Methods: MRI contrasts included FALIR, T1 pre-gadolinium (T1pre), T1 postgadolinium (T1Gd), T2, DWI, ADC, SWI, and MPRAGE. The latter was used for MRI
data registration across preoperative to postoperative scans. Two ROIs were identified by
thresholding preoperative FLAIR (large ROI) and T1Gd (small ROI) images. For each
MRI contrast, a numerical score was assigned based on changing image intensity of both
ROIs (vs. a normal ROI) from preoperative to postoperative stages. The fully-quantitative
method was based on changing image intensity across scans at different stages without
any human intervention, whereas the semi-quantitative method was based on subjective
criteria of cumulative trends across scans at different stages. A fully-quantitative/semiquantitative score per patient was obtained by averaging scores for each MRI contrast. A
standard neuroradiological reading score per patient was obtained from radiological
interpretation of MRI data. Scores from all 3 methods per patient were compared against
patient survival, and re-examined for comorbidity and pathology effects.
Results: Patient survival correlated best with semi-quantitative scores obtained from
T1Gd, ADC, and T2 data, and these correlations improved when biopsy and comorbidity
Conclusion: These results suggest interfacing neuroradiological readings with semiquantitative image analysis can improve predictive accuracy of patient survival.
Hanna, Jonathan, "Prognosticating Brain Tumor Patient Survival After Laser Thermotherapy: Comparison Between Neuroradiological Reading And Semi-Quantitative Analysis Of Mri Data." (2020). Yale Medicine Thesis Digital Library. 3908.