Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in Patients with Glioblastoma

Abstract

Increased ADC values, representing a decrease in infiltrative tumor load, were demonstrated in a limited direct periresectional area. This finding adds to previous studies evaluating ADC response in the larger high-T2 area in relation to survival.

Ventricle contact is associated with lower survival and increased peritumoral perfusion in glioblastoma

“…37 Other studies also demonstrated low ADC within regions associated with infiltrative disease. 6,42 Contrary to our hypothesis, we found no difference in ADC values between GBM patients with ventricle-contacting and noncontacting tumors. This might be explained by a lower reliability of DWI for investigating regions in which tumor infiltration is mixed with edema.…”

Predicting Survival in Glioblastoma Patients Using Diffusion MR Imaging Metrics—A Systematic Review

“…Wen et al [55] found an association between the ADC 10th and 50th percentile with both OS and PFS within the T2-enhanced lesions at 2 months post treatment, while in a study by Lee et al [57], any association with PFS was found between the normalized ADC histogram metrics within the T1 contrast-enhancing lesions. Unfavourable results were also found by Van der Hoorn et al [64], who evaluated the association of the histogram parameters of the post-treatment changes in normalized ADC within the periresectional area with OS and PFS. In this study, the increase in ADC value post-treatment in comparison to pre-treatment did not predict an increase in PFS or OS neither in the univariate nor multivariate survival analysis.…”

“…Other studies on ND-GBM patients investigated the association with OS and PFS of the ADC histogram metrics (normalized or not) obtained performing standard histogram analysis [ 28 , 41 , 48 , 55 , 57 , 62 , 64 , 75 , 76 ] or using a double Gaussian mixture modelling for a histogram of the ADC intensities within the considered region [ 42 , 55 , 61 , 69 ]. Among the studies investigating the standard ADC histogram parameters, six studies investigated the association of the standard ADC histogram metrics with survival outcomes in a postoperative setting [ 28 , 41 , 55 , 57 , 64 , 76 ]. Li et al [ 41 ], in a postoperative setting, found that the median and 10th percentile of the normalized ADC values observed pre-and post-treatment were not associated with OS and PFS in a time-independent analysis, but they were significantly correlated with OS according to a time-dependent survival analysis.…”

“…These metrics, obtained from different tumour zones (e.g., T1 contrast enhancement and non-enhancement and FLAIR signal abnormality), showed prognostic significance in a different study setting for both ND- and R-GBM patients [ 54 , 59 , 63 , 66 , 69 , 76 ]. However, there is no shortage of studies showing adverse results [ 12 , 47 , 57 , 64 ]. A lower number of studies investigated metrics arising from different approaches, such as four-component histogram analysis, fDM maps analysis, radiomics analysis and DTI isotropic and anisotropic components [ 24 , 43 , 49 , 51 , 68 , 74 , 80 , 82 , 83 ].…”

“…In Chakoyan et al [26], patients with large, positive changes in their post-treatment median ADC have a higher OS compared to stable or decreasing ADC changes. Other studies on ND-GBM patients investigated the association with OS and PFS of the ADC histogram metrics (normalized or not) obtained performing standard histogram analysis [28,41,48,55,57,62,64,75,76] or using a double Gaussian mixture modelling for a histogram of the ADC intensities within the considered region [42,55,61,69]. Among the studies investigating the standard ADC histogram parameters, six studies investigated the association of the standard ADC histogram metrics with survival outcomes in a postoperative setting [28,41,55,57,64,76].…”