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

Abstract

Despite advances in surgical and medical treatment of glioblastoma (GBM), the medium survival is about 15 months and varies significantly, with occasional longer survivors and individuals whose tumours show a significant response to therapy with respect to others. Diffusion MRI can provide a quantitative assessment of the intratumoral heterogeneity of GBM infiltration, which is of clinical significance for targeted surgery and therapy, and aimed at improving GBM patient survival. So, the aim of this systematic review is to assess the role of diffusion MRI metrics in predicting survival of patients with GBM. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature search was performed to identify original articles since 2010 that evaluated the association of diffusion MRI metrics with overall survival (OS) and progression-free survival (PFS). The quality of the included studies was evaluated using the QUIPS tool. A total of 52 articles were selected. The most examined metrics were associated with the standard Diffusion Weighted Imaging (DWI) (34 studies) and Diffusion Tensor Imaging (DTI) models (17 studies). Our findings showed that quantitative diffusion MRI metrics provide useful information for predicting survival outcomes in GBM patients, mainly in combination with other clinical and multimodality imaging parameters.

A Predictive Clinical-Radiomics Nomogram for Survival Prediction of Glioblastoma Using MRI

“…Future building of predictive models for survival could induce more accurate and robust models with the addition of further clinical and molecular features. For example, MGMT (O6-methylguanine-DNA methyltransferase) promoter methylation [7], transcriptomic [38], DCE-MRI [16], blood derive biomarkers [39] or diffusion MRI [40] have already been studied for their potential in the survival prediction of GBM patients.…”

Permeability of Hypogymnia physodes Extract Component—Physodic Acid through the Blood–Brain Barrier as an Important Argument for Its Anticancer and Neuroprotective Activity within the Central Nervous System

“…Delicate alterations in the precise mechanisms regulating CNS homeostasis may lead to the progressive loss of structure or function of neurons, which is present in neurodegenerative diseases such as Alzheimer’s (AD), or can cause malignant transformation of cells, leading to brain tumors. Glial tumors are especially formidable, since they are not only the most common primary brain tumors, but also the most aggressive ones—the median survival of glioblastoma, the most common type of glial tumor, is around 15 months [ 4 ] and has not measurably decreased despite huge scientific efforts and novel treatment modalities. Neurodegenerative diseases, such as AD or Parkinson’s disease (PD), are also significant public health care challenges.…”

“…Various mechanisms are important in the development of CNS pathological changes. Oxidative stress and many other processes (for example, inflammation, mitochondrial dysfunction, apoptosis) are considered the cause of CNS diseases [ 4 , 6 ]. Reactive oxygen species (ROS), resulting among others, from the metabolic transformations of neurotransmitters can attack sensitive glial cells and neurons, leading to the damage of CNS structures [ 7 , 8 ].…”

Multiregional Sequencing of IDH-WT Glioblastoma Reveals High Genetic Heterogeneity and a Dynamic Evolutionary History

“…GB is the most frequent brain tumor in adults and is characterized by an invariably fatal prognosis [ 32 ]. With optimal treatment, the median survival of patients is just over 1 year and only 18% survive two years [ 33 ].…”