Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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T2 Mapping with and without Fat-Suppression to Predict Treatment Response to Intravenous Glucocorticoid Therapy for Thyroid-Associated Ophthalmopathy

  • Linhan Zhai (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Qiuxia Wang (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Ping Liu (Department of Medical Imaging, Guangdong Second Provincial General Hospital) ;
  • Ban Luo (Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Gang Yuan (Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Jing Zhang (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology)
  • Received : 2021.08.09
  • Accepted : 2022.03.15
  • Published : 2022.06.01
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Abstract

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.

Keywords

Acknowledgement

We would like to thank Editage (www.editage.cn) for English language editing.

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