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Journal of Neuro-Oncology

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Open Access 01-01-2020 | Glioblastoma | Clinical Study

Whole brain apparent diffusion coefficient measurements correlate with survival in glioblastoma patients

Authors: Aaron Michael Rulseh, Josef Vymazal

Published in: Journal of Neuro-Oncology | Issue 1/2020

Abstract

Introduction

Glioblastoma (GBM) is the most common malignant primary brain tumor, and methods to improve the early detection of disease progression and evaluate treatment response are highly desirable. We therefore explored changes in whole-brain apparent diffusion coefficient (ADC) values with respect to survival (progression-free [PFS], overall [OS]) in a cohort of GBM patients followed at regular intervals until disease progression.

Methods

A total of 43 subjects met inclusion criteria and were analyzed retrospectively. Histogram data were extracted from standardized whole-brain ADC maps including skewness, kurtosis, entropy, median, mode, 15th percentile (p15) and 85th percentile (p85) values, and linear regression slopes (metrics versus time) were fitted. Regression slope directionality (positive/negative) was subjected to univariate Cox regression. The final model was determined by aLASSO on metrics above threshold.

Results

Skewness, kurtosis, median, p15 and p85 were all below threshold for both PFS and OS and were analyzed further. Median regression slope directionality best modeled PFS (p = 0.001; HR 3.3; 95% CI 1.6–6.7), while p85 was selected for OS (p = 0.002; HR 0.29; 95% CI 0.13–0.64).

Conclusions

Our data show tantalizing potential in the use of whole-brain ADC measurements in the follow up of GBM patients, specifically serial median ADC values which correlated with PFS, and serial p85 values which correlated with OS. Whole-brain ADC measurements are fast and easy to perform, and free of ROI-placement bias.

Tamimi AF, Juweid M (2017) Epidemiology and outcome of glioblastoma. In: De Vleeschouwer S (ed) Glioblastoma. Codon Publications, Brisbane

Dehdashti AR, Hegi ME, Regli L et al (2006) New trends in the medical management of glioblastoma multiforme: the role of temozolomide chemotherapy. Neurosurg Focus 20:E6. https://doi.org/10.3171/foc.2006.20.4.3 CrossRefPubMed

Stupp R, Taillibert S, Kanner A et al (2017) Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial. JAMA 318:2306–2316. https://doi.org/10.1001/jama.2017.18718 CrossRefPubMedPubMedCentral

Tykocki T, Eltayeb M (2018) Ten-year survival in glioblastoma. A systematic review. J Clin Neurosci 54:7–13. https://doi.org/10.1016/j.jocn.2018.05.002 CrossRefPubMed

Kondo M, Uchiyama Y (2018) Apparent diffusion coefficient histogram analysis for prediction of prognosis in glioblastoma. J Neuroradiol 45:236–241. https://doi.org/10.1016/j.neurad.2017.11.011 CrossRefPubMed

Mehrabian H, Lam WW, Myrehaug S et al (2018) Glioblastoma (GBM) effects on quantitative MRI of contralateral normal appearing white matter. J Neurooncol 139:97–106. https://doi.org/10.1007/s11060-018-2846-0 CrossRefPubMed

Jenkinson M, Beckmann CF, Behrens TEJ et al (2012) FSL Neuroimage 62:782–790. https://doi.org/10.1016/j.neuroimage.2011.09.015 CrossRefPubMed

Lu W, Zhang HH (2007) Variable selection for proportional odds model. Stat Med 26:3771–3781. https://doi.org/10.1002/sim.2833 CrossRefPubMed

Khalifa J, Tensaouti F, Lotterie J-A et al (2016) Do perfusion and diffusion MRI predict glioblastoma relapse sites following chemoradiation? J Neurooncol 130:181–192. https://doi.org/10.1007/s11060-016-2232-8 CrossRefPubMed

10.

Kong Z, Yan C, Zhu R et al (2018) Imaging biomarkers guided anti-angiogenic therapy for malignant gliomas. Neuroimage Clin 20:51–60. https://doi.org/10.1016/j.nicl.2018.07.001 CrossRefPubMedPubMedCentral

11.

Rulseh AM, Keller J, Klener J et al (2012) Long-term survival of patients suffering from glioblastoma multiforme treated with tumor-treating fields. World J Surg Oncol 10:220. https://doi.org/10.1186/1477-7819-10-220 CrossRefPubMedPubMedCentral

12.

Vymazal J, Zacek R, Sroubek J et al (2017) Quantitative MR measurements in glioblastoma patients: difference in mean diffusivity between Optune patients and patients with only standard treatment. Neuro Oncol 19(Suppl 6):vi143. https://doi.org/10.1093/neuonc/nox168.584 CrossRefPubMedCentral

13.

Sahm F, Capper D, Jeibmann A et al (2012) Addressing diffuse glioma as a systemic brain disease with single-cell analysis. Arch Neurol 69:523–526. https://doi.org/10.1001/archneurol.2011.2910 CrossRefPubMed

14.

Cordova JS, Shu H-KG, Liang Z et al (2016) Whole-brain spectroscopic MRI biomarkers identify infiltrating margins in glioblastoma patients. Neuro Oncol 18:1180–1189. https://doi.org/10.1093/neuonc/now036 CrossRefPubMedPubMedCentral

15.

Wen PY, Macdonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972. https://doi.org/10.1200/JCO.2009.26.3541 CrossRefPubMed

16.

Macdonald DR, Cascino TL, Schold SC, Cairncross JG (1990) Response criteria for phase II studies of supratentorial malignant glioma. JCO 8:1277–1280. https://doi.org/10.1200/JCO.1990.8.7.1277 CrossRef

17.

Schmeel FC (2019) Variability in quantitative diffusion-weighted MR imaging (DWI) across different scanners and imaging sites: is there a potential consensus that can help reducing the limits of expected bias? Eur Radiol 29:2243–2245. https://doi.org/10.1007/s00330-018-5866-4 CrossRefPubMed

Title: Whole brain apparent diffusion coefficient measurements correlate with survival in glioblastoma patients
Authors: Aaron Michael Rulseh
Josef Vymazal
Publication date: 01-01-2020
Publisher: Springer US
Keywords: Glioblastoma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Glioblastoma
Glioblastoma
Published in: Journal of Neuro-Oncology / Issue 1/2020
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03357-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Whole brain apparent diffusion coefficient measurements correlate with survival in glioblastoma patients

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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