Apparent diffusion coefficient as a valuable quantitative parameter for predicting clinical outcomes in patients with newly diagnosed primary CNS lymphoma

Baek, Dong Won; Cho, Hee Jeong; Bae, Jae Heung; Sohn, Sang Kyun; Moon, Joon Ho

doi:10.5045/br.2020.2020032

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…The Memorial Sloan Kettering Cancer Center prognostic score utilizes age and Karnofsky performance status as important features. For imaging, the apparent diffusion coefficient value (ADC) derived from MRI seems to be a promising imaging biomarker, which can provide additional prognostic value (16).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Quality and Distribution of Adipose Tissue in Patients With Primary Central Nervous System Lymphoma

Hinnerichs

Ferraro

Zeremski

et al. 2022

In Vivo

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Background/Aim: Body composition assessment has shown promising results as a prognostic biomarker as depicted by cross-sectional imaging of several tumor entities including lymphomas. The present study sought to elucidate the prognostic relevance of subcutaneous and visceral fat tissue (SAT and VAT) in patients with primary central nervous system lymphoma (PCNSL). Patients and Methods: Overall, 74 patients (36 female patients, 46.7%) with a mean age of 64.2±12.8 years (range=23-81 years) were identified in the database with sufficient clinical and imaging data and included into this retrospective study. Fat area assessment was performed on one axial slide on L3-height derived from staging computed tomography (CT) images. Subcutaneous, visceral, and intramuscular adipose tissues (SAT, VAT, IMAT) were estimated. Also, density of SAT, VAT, and IMAT were estimated. Finally, the ratio VAT/SAT (VSR) was calculated. Overall and progression-free survival (OS and PFS) were used as study end points. Results: In the observation period, overall, 47 patients (63.5%) died. Mean OS was 33.8±45.4 months and mean PFS was 26.6±42.7 months. The mean VAT value was 162±99.5 cm 2 , the mean SAT was 202.4±103.3 cm 2 , the mean VSR was 0.92±0.69. The hazard ratios (HRs) for overall survival were 0.87 for high VAT, 1.52 for SAT, and 0.73 for VSR in univariable analysis. For PFS it was 0.24 for VAT, 1.11 for SAT, and 1.07 for VSR. No values achieved statistical significance. Similar results were shown in Kaplan-Meier analysis for OS and PFS, respectively. Conclusion: Parameters of adipose tissue are not associated with OS and PFS in patients with PCNSL.

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Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Quality and Distribution of Adipose Tissue in Patients With Primary Central Nervous System Lymphoma

Hinnerichs

Ferraro

Zeremski

et al. 2022

In Vivo

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“…Nevertheless, several ADC-derived metrics have a prognostic and predictive value in PCNSL. In immunocompetent patients, baseline lower ADC values reflect higher cellular density and are associated with shorter PFS and OS in multivariate analysis [32,[49][50][51][52].…”

Section: Diffusion Mrimentioning

confidence: 99%

Prognostic factors in primary central nervous system lymphoma

Morales-Martínez¹,

Nichelli

Hernández-Verdin

et al. 2022

Current Opinion in Oncology

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Purpose of reviewPrimary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal diffuse large B cell lymphoma. Despite its apparent immunopathological homogeneity, PCNSL displays a wide variability in outcome. Identifying prognostic factors is of importance for patient stratification and clinical decision-making. The purpose of this review is to focus on the clinical, neuroradiological and biological variables correlated with the prognosis at the time of diagnosis in immunocompetent patients.Recent findingsAge and performance status remain the most consistent clinical prognostic factors. The current literature suggests that neurocognitive dysfunction is an independent predictor of poor outcome. Cumulating data support the prognostic value of increased interleukin-10 level in the cerebrospinal fluid (CSF), in addition to its interest as a diagnostic biomarker. Advances in neuroimaging and in omics have identified several semi-quantitative radiological features (apparent diffusion restriction measures, dynamic contrast-enhanced perfusion MRI (pMRI) pattern and 18F-fluorodeoxyglucose metabolism) and molecular genetic alterations with prognostic impact in PCNSL.SummaryValidation of new biologic and neuroimaging markers in prospective studies is required before integrating future prognostic scoring systems. In the era of radiomic, large clinicoradiological and molecular databases are needed to develop multimodal artificial intelligence algorithms for the prediction of accurate outcome.

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“…Concentration of interleukin-10 in the CSF has also been associated with treatment response and duration ( 68 , 82 ). Imaging biomarkers are also the source of much interest with recent work suggesting correlations between perfusion imaging, diffusion-weighted sequences, or texture parameters to outcome measures ( 83 – 86 ).…”

Section: Goals For Future Studiesmentioning

confidence: 99%

Primary central nervous system lymphoma: a narrative review of ongoing clinical trials and goals for future studies

Schaff¹,

Ambady²,

Doolittle³

et al. 2021

Ann Lymphoma

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Primary central nervous system lymphoma (PCNSL) is a rare disease of the brain, spine, cerebrospinal fluid (CSF) and/or vitreoretinal space. PCNSL is chemo and radiosensitive but relapse is common even years after initial treatment. Outside of consensus regarding the use of high-dose methotrexate (HD-MTX) for first line treatment, there is little uniformity in the management of newly diagnosed or relapsed PCNSL. The lack of consensus is driven by a paucity of randomized trials in this disease. Prospective studies are troubled by low enrollment, the lack of a standard induction regimen, and a varied approach to consolidation strategies. Moreover, the PCNSL patient population is heterogeneous and includes a high proportion of elderly or frail patients and consists of patients manifesting disease in varied compartments of the central nervous system (CNS). As a result, current treatment strategies vary widely and are often dictated by physician and institutional preference or regional practice. This review provides an overview of recently completed and ongoing therapeutic studies for patients with newly diagnosed and recurrent or refractory PCNSL. It discusses the existing evidence behind common approaches to induction and consolidation or maintenance regimens as well as the recent data regarding management of recurrent disease. Finally, it highlights the complexity of trial design in this disease and provides a framework for the design of future studies, which are needed to identify patient populations likely to benefit from specific induction, consolidation, or maintenance therapies.

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Apparent diffusion coefficient as a valuable quantitative parameter for predicting clinical outcomes in patients with newly diagnosed primary CNS lymphoma

Cited by 12 publications

References 29 publications

Prognostic Impact of Quality and Distribution of Adipose Tissue in Patients With Primary Central Nervous System Lymphoma

Prognostic Impact of Quality and Distribution of Adipose Tissue in Patients With Primary Central Nervous System Lymphoma

Prognostic factors in primary central nervous system lymphoma

Primary central nervous system lymphoma: a narrative review of ongoing clinical trials and goals for future studies

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