The value of intravoxel incoherent motion imaging in predicting the survival of patients with astrocytoma

Abstract

Background The evaluation of the prognosis of gliomas may have great value in individualized treatment. Purpose To evaluate the value of intravoxel incoherent motion (IVIM) in predicting the survival of patients with astrocytoma and comparing it to apparent diffusion coefficients (ADC). Material and Methods Sixty patients with pathologically confirmed cerebral astrocytomas underwent IVIM scans before any treatment was performed. Patients were divided into death group and survival group according to a two-year follow-up. ADC and quantitative parameters of IVIM including D, D*, and f were measured. Independent sample t test was used to compare the two groups of parameters. The accuracy of each parameter for two-year survival rate was analyzed by receiver operating characteristic (ROC) curve and Kaplan–Meier survival curves. The correlation between quantitative parameters and survival days was analyzed by Pearson correlation analysis. Results The ADC, D*, and f values were statistically significant different between the death and the survival groups ( P < 0.05). The AUC of the ADC, D*, and f were 0.811, 0.858, and 0.892, respectively. The ADC cut-off value of 0.668 × 10−3 mm2/s corresponded to 82.6% sensitivity and 73% specificity. The D* cut-off value of 3.913 × 10−3 mm2/s corresponded to 78.4% sensitivity and 87% specificity. The f cut-off value of 0.487 corresponded to 83.8% sensitivity and 87% specificity. Significant log rank test was performed for each parameter to predict overall survival ( P < 0.05). There was a correlation between ADC ( r = 0.625, P = 0.023), D* ( r = −0.655, P = 0.012), f ( r = −0.725, P = 0.000) and survival days. Conclusion The D* and f values demonstrated great potential in predicting the two-year survival rate for patients with astrocytoma.

Hemodynamic Imaging in Cerebral Diffuse Glioma—Part B: Molecular Correlates, Treatment Effect Monitoring, Prognosis, and Future Directions

“…This technique yields three parameters, i.e., perfusion fraction (f) which is a measure proportional to CBV, pseudodiffusion coefficient (D *), and blood-flow related parameters fD *, and it has been the focus of brain tumor research as well. Similar to traditional hemodynamic imaging, IVIM-MRI has been also used for differential diagnosis (perfusion fraction is increased in high-grade compared with low-grade gliomas, and it allows for the differentiation of cerebral lymphomas—lower f versus high-grade glioma) [ 178 , 179 , 180 ], glioma grading, and IDH mutation prediction [ 181 , 182 , 183 , 184 ] to monitor the treatment effects [ 185 , 186 , 187 ], to identify tumor progression [ 109 ], and to predict survival [ 188 , 189 , 190 ].…”