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

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Peer-reviewed

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Type

Article

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Authors

van der Hoorn, Anouk 
Yan, Jiun-Lin 
Larkin, Timothy J 
Boonzaier, Natalie R 

Abstract

BACKGROUND: Although targeted by radiotherapy, recurrence in glioblastoma occurs mainly periresectionally owing to tumor infiltration. An increase in the apparent diffusion coefficient (ADC) has been shown in the large high-T2 area on magnetic resonance imaging posttreatment; however, until now ADC has not been investigated directly in the more relevant periresectional area. METHODS: Histogram analysis was used to assess periresectional ADC values in patients with glioblastoma postradiotherapy versus preradiotherapy. Periresectional ADC values starting at 0-5 mm in 5-mm increments up to 20-25 mm were extracted and compared using 2-way repeated-measurements analysis of variance. RESULTS: Mean ADC values directly adjacent to the resection area (0-5 mm) were significantly higher postradiotherapy compared with preradiotherapy (P = .017). ADC values in the 0- to 5-mm region were also higher than those in 5- to 10-, 10- to 15-, and 15- to 20-mm regions (P < .05). Regional standard deviations in ADC values were higher postradiotherapy compared with preradiotherapy for the 0- to 5-mm region up to the 15- to 20-mm region, inclusive (P < .05); however, Cox regression analysis showed no survival benefits from the increased ADC in the 0- to 5-mm region postradiotherapy. CONCLUSIONS: 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.

Description

Keywords

Apparent diffusion coefficient, Brain tumor, Glioblastoma, Magnetic resonance imaging, Treatment response, Aged, Brain Neoplasms, Cohort Studies, Diffusion Magnetic Resonance Imaging, Female, Glioblastoma, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Neoplasm Recurrence, Local, Regression Analysis, Survival Analysis, Treatment Outcome, Tumor Burden

Journal Title

World Neurosurg

Conference Name

Journal ISSN

1878-8750
1878-8769

Volume Title

Publisher

Elsevier BV