Format

Send to

Choose Destination
Insights Imaging. 2019 Mar 18;10(1):36. doi: 10.1186/s13244-019-0724-8.

Pre-operative apparent diffusion coefficient values and tumour region volumes as prognostic biomarkers in glioblastoma: correlation and progression-free survival analyses.

Author information

1
Department of Internal Medicine, Medica Sur Clinic and Foundation, Mexico City, Mexico.
2
Department of Neurosurgery, Secretariat of Health, General Hospital of Mexico, Mexico City, Mexico.
3
Radioneurosurgery Unit, The National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
4
Directorate of Research, Secretariat of Health, General Hospital of Mexico, Mexico City, Mexico. ernest.roldan@usa.net.
5
Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya str., 8, b. 2, Moscow, Russia, 119992. ernest.roldan@usa.net.

Abstract

OBJECTIVES:

Glioblastoma (GB) contains diverse histologic regions. Apparent diffusion coefficient (ADC) values are surrogates for the degree of number of cells within the tumour regions. Because an assessment of ADC values and volumes within tumour sub-compartments of GB is missing in the literature, we aimed to evaluate these associations.

METHODS:

A retrospective cohort of 48 patients with GB underwent segmentation to calculate tumour region volumes (in cubic centimetre) and ADC values in tumour regions: normal tissue, enhancing tumour, proximal oedema, distal oedema, and necrosis. Correlation, Kaplan-Meier, and Cox hazard regression analyses were performed.

RESULTS:

We found a statistically significant difference among ADC values for tumour regions: F (4, 220) = 166.71 and p ≤ .001 and tumour region volumes (necrosis, enhancing tumour, peritumoural oedema): F (2, 141) = 136.3 and p ≤ .001. Post hoc comparisons indicated that the only significantly different mean score was the peritumoural volume in oedema region (p < .001). We observed a positive significant correlation between ADC of distal oedema and peritumoural volume, r = .418, df = 34, and p = .011. Cox proportional hazards regression analysis considering only tumour region volumes provided an almost significant model: - 2 log-likelihood = 146.066, χ2 (4) = 9.303, and p = .054 with a trend towards significance of the hazard function: p = .067 and HR = 1.077 for the non-enhancing tumour volume.

CONCLUSIONS:

ADC values together with volumes of oedema region might have a role as predictors of progression-free survival (PFS) in patients with GB; we recommend a routine MRI assessment with the calculation of these biomarkers in GB.

KEYWORDS:

Brain neoplasms; Diffusion magnetic resonance imaging; Glioblastoma; Neuroimaging; Progression-free survival; Regression analysis

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center