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Tomography
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10.18383/j.tom.2015.00115
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Tomography is published by MDPI from Volume 7 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Grapho, LLC.
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Communication

Diffusion MRI Characteristics after Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma

by
Warren Chang
1,
Whitney B. Pope
1,
Robert J. Harris
1,2,
Anthony J. Hardy
1,2,
Kevin Leu
1,5,
Reema R. Mody
3,6,
Phioanh L. Nghiemphu
3,6,
Albert Lai
3,6,
Timothy F. Cloughesy
3,6 and
Benjamin M. Ellingson
1,2,4,5,6,*
1
Department of Radiological Sciences, University of California, Los Angeles, CA 90024, USA
2
Department of Biomedical Physics, University of California, Los Angeles, CA 90024, USA
3
Department of Neurology, University of California, Los Angeles, CA 90024, USA
4
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, USA
5
Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, CA 90024, USA
6
Neuro-Oncology Program, University of California, Los Angeles, CA 90024, USA
*
Author to whom correspondence should be addressed.
Tomography 2015, 1(1), 37-43; https://doi.org/10.18383/j.tom.2015.00115
Submission received: 3 June 2015 / Revised: 7 July 2015 / Accepted: 13 August 2015 / Published: 1 September 2015
Versions Notes

Abstract

The standard of care for newly diagnosed glioblastoma (GBM) is surgery first, radiotherapy (RT) with concurrent temozolomide (TMZ) second, and adjuvant TMZ last. We hypothesized patients with low diffusivity measured using apparent diffusion coefficient (ADC) histogram analysis evaluated after RT + TMZ and before adjuvant TMZ would have a significantly shorter progression-free survival (PFS) and overall survival (OS). To test this hypothesis, we evaluated 120 patients with newly diagnosed GBM receiving RT + TMZ followed by adjuvant TMZ. Magnetic resonance imaging was performed after completing RT + TMZ and before initiating adjuvant TMZ. A double Gaussian mixed model was used to describe the ADC histograms within the enhancing tumor, where ADCL and ADCH were defined as the mean ADC value of the lower and higher Gaussian distribution, respectively. An ADCL value of 1.0 μm2/ms and ADCH value of 1.6 μm2/ms were used to stratify patients into high- and low-risk categories. Results suggested that patients with a low ADCL had a significantly shorter PFS (Cox hazard ratio = 0.12, P = 0.0006). OS was significantly shorter with low ADCL tumors, showing a median OS of 407 versus 644 days (Cox hazard ratio = 0.31, P = 0.047). ADCH did not predict PFS or OS when accounting for age and ADCL. In summary, after completing RT + TMZ, newly diagnosed glioblastoma patients with a low ADCL are likely to progress and die earlier than patients with a higher ADCL. ADC histogram analysis may be useful for patient-risk stratification after completing RT + TMZ.
Keywords: glioblastoma; ADC histogram analysis; diffusion MRI glioblastoma; ADC histogram analysis; diffusion MRI

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MDPI and ACS Style

Chang, W.; Pope, W.B.; Harris, R.J.; Hardy, A.J.; Leu, K.; Mody, R.R.; Nghiemphu, P.L.; Lai, A.; Cloughesy, T.F.; Ellingson, B.M. Diffusion MRI Characteristics after Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma. Tomography 2015, 1, 37-43. https://doi.org/10.18383/j.tom.2015.00115

AMA Style

Chang W, Pope WB, Harris RJ, Hardy AJ, Leu K, Mody RR, Nghiemphu PL, Lai A, Cloughesy TF, Ellingson BM. Diffusion MRI Characteristics after Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma. Tomography. 2015; 1(1):37-43. https://doi.org/10.18383/j.tom.2015.00115

Chicago/Turabian Style

Chang, Warren, Whitney B. Pope, Robert J. Harris, Anthony J. Hardy, Kevin Leu, Reema R. Mody, Phioanh L. Nghiemphu, Albert Lai, Timothy F. Cloughesy, and Benjamin M. Ellingson. 2015. "Diffusion MRI Characteristics after Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma" Tomography 1, no. 1: 37-43. https://doi.org/10.18383/j.tom.2015.00115

APA Style

Chang, W., Pope, W. B., Harris, R. J., Hardy, A. J., Leu, K., Mody, R. R., Nghiemphu, P. L., Lai, A., Cloughesy, T. F., & Ellingson, B. M. (2015). Diffusion MRI Characteristics after Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma. Tomography, 1(1), 37-43. https://doi.org/10.18383/j.tom.2015.00115

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