Role of the apparent diffusion coefficient as a predictive factor for tumor recurrence in patients with intracranial epidermoid tumor

Abstract

Purpose. Intracranial epidermoid tumors are slowly growing benign tumors, but due to adjacent critical neurovascular structures, surgical resection is challenging, with the risk of recurrence. The apparent diffusion coefficient (ADC) has been used to evaluate the characteristics of brain tumors, but its utility for intracranial epidermoid tumors has not been specifically explored. This study analyzed the utility of preoperative ADC values in predicting tumor recurrence for patients with intracranial epidermoid tumors. Methods. Between 2008 and 2019, 23 patients underwent surgery for intracranial epidermoid tumor, and their preoperative ADC data were analyzed. The patients were divided into two groups: the recurrence group, defined by regrowth of the remnant tumor or newly developed mass after gross total resection on magnetic resonance imaging (MRI); and the stable group, defined by the absence of growth or evidence of tumor on MRI. Receiver operating characteristic (ROC) analysis was used to obtain the ADC cutoff values for predicting tumor recurrence. The prognostic value of the ADC was assessed using Kaplan-Meier curves. Results. The minimum ADC values were significantly lower in the recurrence group than in the stable tumor group (P = 0.046). ROC analysis showed that a minimum ADC value lower than 804.5×10− 6 mm2/s could be used to predict higher recurrence risk of intracranial epidermoid tumors. Subtotal resection, younger age, and mean and minimum ADC values lower than the respective cutoffs were negative predictors of recurrence-free survival. Conclusions. Minimum ADC values could be useful in predicting the recurrence of intracranial epidermoid tumors.