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Li Z, Wang X, Zhang H, Yang Y, Zhang Y, Zhuang Y, Yang Q, Gao E, Ren Y, Zhang Y, Cai S, Chen Z, Cai C, Dong Y, Bao J, Cheng J. Positive Progesterone Receptor Expression in Meningioma May Increase the Transverse Relaxation: First Prospective Clinical Trial Using Single-Shot Ultrafast T 2 Mapping. Acad Radiol 2024; 31:187-198. [PMID: 37316368 DOI: 10.1016/j.acra.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 06/16/2023]
Abstract
RATIONALE AND OBJECTIVES This project aims to investigate the diagnostic performance of multiple overlapping-echo detachment imaging (MOLED) technique-derived transverse relaxation time (T2) maps in predicting progesterone receptor (PR) and S100 expression in meningiomas. MATERIALS AND METHODS 63 meningioma patients were enrolled from October 2021 to August 2022, who underwent a complete routine magnetic resonance imaging and T2 MOLED, which can characterize the whole brain transverse relaxation time within 32 seconds in a single scan. After the surgical resection of meningiomas, the expression levels of PR and S100 were determined by an experienced pathologist using immunohistochemistry techniques. Histogram analysis was performed in tumor parenchyma based on the parametric maps. Independent t test and Mann-Whitney U test were applied for the comparison of histogram parameters between different groups, with a significance level of P < .05. Logistic regression and receiver operating characteristic (ROC) analysis with 95% confidence interval were conducted for the diagnostic efficiency evaluation. RESULTS PR-positive group had significantly elevated T2 histogram parameters (P = .001-.049) compared to the PR-negative group. The multivariate logistic regression model with T2 showed the highest area under the ROC curve (AUC) for predicting PR expression (AUC=0.818). Additionally, the multivariate model also had the best diagnostic performance for predicting meningioma S100 expression (AUC=0.768). CONCLUSION The MOLED technique-derived T2 maps can distinguish PR and S100 status in meningiomas preoperatively.
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Affiliation(s)
- Zongye Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Xiao Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Hongyan Zhang
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China (H.Z.)
| | - Yijie Yang
- Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen, China (Y.Y., Q.Y., S.C., Z.C., C.C.)
| | - Yue Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Yuchuan Zhuang
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York (Y.Z.)
| | - Qinqin Yang
- Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen, China (Y.Y., Q.Y., S.C., Z.C., C.C.)
| | - Eryuan Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Yanan Ren
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Shuhui Cai
- Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen, China (Y.Y., Q.Y., S.C., Z.C., C.C.)
| | - Zhong Chen
- Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen, China (Y.Y., Q.Y., S.C., Z.C., C.C.)
| | - Congbo Cai
- Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen, China (Y.Y., Q.Y., S.C., Z.C., C.C.)
| | - Yanbo Dong
- Institute of Psychology, Herzen State Pedagogical University of Russia, Saint Petersburg, Russia (Y.D.)
| | - Jianfeng Bao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.)
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou 450000, China (Z.L., X.W., Y.Z., E.G., Y.R., Y.Z., J.B., J.C.).
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Ji Y, Rankin C, Grunberg S, Sherrod AE, Ahmadi J, Townsend JJ, Feun LG, Fredericks RK, Russell CA, Kabbinavar FF, Stelzer KJ, Schott A, Verschraegen C. Double-Blind Phase III Randomized Trial of the Antiprogestin Agent Mifepristone in the Treatment of Unresectable Meningioma: SWOG S9005. J Clin Oncol 2015; 33:4093-8. [PMID: 26527781 DOI: 10.1200/jco.2015.61.6490] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Progesterone receptors are expressed in approximately 70% of meningiomas. Mifepristone is an oral antiprogestational agent reported to have modest activity in a phase II study. This multicenter, prospective, randomized, placebo-controlled phase III trial conducted by SWOG was planned to define the role of mifepristone in the treatment of unresectable meningioma. PATIENTS AND METHODS Eligible patients were randomly assigned to receive either mifepristone or placebo for 2 years unless disease progressed. Patients who were stable or responding to protocol therapy after 2 years had the option to continue with the same blinded therapy. Serial follow-up allowed assessment of efficacy and toxicity. Time to treatment failure and overall survival were ascertained for all randomly assigned patients. On progression, patients receiving placebo could cross over and receive active drug. RESULTS Among 164 eligible patients, 80 were randomly assigned to mifepristone and 84 to placebo. Twenty-four patients (30%) were able to complete 2 years of mifepristone without disease progression, adverse effects, or other reasons for discontinuation. Twenty-eight patients (33%) in the placebo arm completed the 2-year study. There was no statistical difference between the arms in terms of failure-free or overall survival. CONCLUSION Long-term administration of mifepristone was well tolerated but had no impact on patients with unresectable meningioma.
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Affiliation(s)
- Yongli Ji
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Cathryn Rankin
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Steven Grunberg
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Andy E Sherrod
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Jamshid Ahmadi
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Jeannette J Townsend
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Lynn G Feun
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Ruth K Fredericks
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Christy A Russell
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Fairooz F Kabbinavar
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Keith J Stelzer
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Anne Schott
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI
| | - Claire Verschraegen
- Yongli Ji, Steven Grunberg, and Claire Verschraegen, University of Vermont Cancer Center, Burlington, VT; Cathryn Rankin, SWOG Statistical Center, Seattle, WA; Andy E. Sherrod, Jamshid Ahmadi, and Christy A. Russell, University of Southern California; Fairooz F. Kabbinavar, University of California Los Angeles, Los Angeles, CA; Jeannette J. Townsend, University of Utah Medical Center, Salt Lake City, UT; Lynn G. Feun, University of Miami, Miami, FL; Ruth K. Fredericks, University of Mississippi Medical Center, Jackson, MS; Keith J. Stelzer, Celilo Cancer Center, the Dalles, OR; and Anne Schott, University of Michigan, Ann Arbor, MI.
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