TY - JOUR
T1 - Intravoxel incoherent motion metrics as potential biomarkers for survival in glioblastoma
AU - Puig, Josep
AU - Sánchez-González, Javier
AU - Blasco, Gerard
AU - Daunis-I-Estadella, Pepus
AU - Federau, Christian
AU - Alberich-Bayarri, Ángel
AU - Biarnes, Carles
AU - Nael, Kambiz
AU - Essig, Marco
AU - Jain, Rajan
AU - Wintermark, Max
AU - Pedraza, Salvador
N1 - Publisher Copyright:
© 2016 Puig et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/7
Y1 - 2016/7
N2 - Objective: Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma. Methods: Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D∗), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses. Results: We found that fCER and D∗CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D∗CER>21.712×10-3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162-25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy. Conclusions: The IVIM-metrics fCER and D∗CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.
AB - Objective: Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma. Methods: Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D∗), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses. Results: We found that fCER and D∗CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D∗CER>21.712×10-3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162-25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy. Conclusions: The IVIM-metrics fCER and D∗CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.
UR - https://www.scopus.com/pages/publications/84978733950
UR - https://www.scopus.com/pages/publications/84978733950#tab=citedBy
U2 - 10.1371/journal.pone.0158887
DO - 10.1371/journal.pone.0158887
M3 - Article
C2 - 27387822
AN - SCOPUS:84978733950
SN - 1932-6203
VL - 11
JO - PloS one
JF - PloS one
IS - 7
M1 - e0158887
ER -