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01-05-2015 | Clinical Study

Evaluation of absolute and normalized apparent diffusion coefficient (ADC) values within the post-operative T2/FLAIR volume as adverse prognostic indicators in glioblastoma

Authors: Andrew Elson, Joseph Bovi, Malika Siker, Chris Schultz, Eric Paulson

Published in: Journal of Neuro-Oncology | Issue 3/2015

Abstract

To evaluate the association of normalized and absolute ADC metrics with progression free survival (PFS) and overall survival (OS) in patients treated for glioblastoma multiforme (GBM). Fifty-two patients with preradiotherapy diffusion weighted imaging treated with post-operative chemoradiation for GBM were evaluated. Region of interest analysis for ADC metrics including mean and minimum ADC value (ADC_mean) and (ADC_min) was performed within the T2/FLAIR volume. Normalized _(N)ADC values were generated relative to contralateral white matter. PFS and OS were analyzed relative to ADC parameters using a regression model. Kaplan–Meier and Cox proportional hazards analysis with respect to _(N)ADC_mean, and _(N)ADC_min was performed. A _(N)ADC threshold <1.3 within the T2/FLAIR volume was analyzed with respect to PFS and OS. Regression analysis indicated that normalized ADC values provide the strongest association with PFS and OS. Kaplan–Meier analysis revealed a non-significant trend toward inferior PFS and OS associated with _(N)ADC_mean <1.7, and a significant decrement to PFS and OS associated with _(N)ADC_min <0.3. _(N)ADC_min was a significant prognostic factor when taking into account age, performance status, and extent of resection. ADC thresholding analysis revealed that a retained volume of >0.45 cc per mL FLAIR volume was associated with a trend toward inferior PFS and OS. In the post-operative, pre-radiotherapy setting, the _(N)ADC_min is the strongest predictor of outcomes in patients treated for GBM. ADC thresholding analysis indicates that a large volume of normalized ADC value <1.3 may be associated with adverse outcomes.

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Title: Evaluation of absolute and normalized apparent diffusion coefficient (ADC) values within the post-operative T2/FLAIR volume as adverse prognostic indicators in glioblastoma
Authors: Andrew Elson
Joseph Bovi
Malika Siker
Chris Schultz
Eric Paulson
Publication date: 01-05-2015
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2015
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-015-1743-z

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Evaluation of absolute and normalized apparent diffusion coefficient (ADC) values within the post-operative T2/FLAIR volume as adverse prognostic indicators in glioblastoma

Abstract

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Abstract

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