ADC Values and Prognosis of Malignant Astrocytomas: Does Lower ADC Predict a Worse Prognosis Independent of Grade of Tumor?—A Meta-Analysis

Zulfiqar, Maria; Yousem, David M.; Li, Hong

doi:10.2214/ajr.12.8679

Cited by 71 publications

(55 citation statements)

References 19 publications

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“…Low diffusivity predicts poor astrocytoma survival independent from WHO grade [38], although no linear relation exists between ADC and glioma prognosis [39]. …”

Section: Discussionmentioning

confidence: 99%

Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis

et al. 2018

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ObjectivesTo investigate if quantitative apparent diffusion coefficient (ADC) measurements can predict genetic subtypes of non-gadolinium-enhancing gliomas, comparing whole tumour against single slice analysis.MethodsVolumetric T2-derived masks of 44 gliomas were co-registered to ADC maps with ADC mean (ADCmean) calculated. For the slice analysis, two observers placed regions of interest in the largest tumour cross-section. The ratio (ADCratio) between ADCmean in the tumour and normal appearing white matter was calculated for both methods.ResultsIsocitrate dehydrogenase (IDH) wild-type gliomas showed the lowest ADC values throughout (p < 0.001). ADCmean in the IDH-mutant 1p19q intact group was significantly higher than in the IDH-mutant 1p19q co-deleted group (p < 0.01). A volumetric ADCmean threshold of 1201 × 10−6 mm2/s identified IDH wild-type with a sensitivity of 83% and a specificity of 86%; a volumetric ADCratio cut-off value of 1.65 provided a sensitivity of 80% and a specificity of 92% (area under the curve (AUC) 0.9–0.94). A slice ADCratio threshold for observer 1 (observer 2) of 1.76 (1.83) provided a sensitivity of 80% (86%), specificity of 91% (100%) and AUC of 0.95 (0.96). The intraclass correlation coefficient was excellent (0.98).ConclusionsADC measurements can support the distinction of glioma subtypes. Volumetric and two-dimensional measurements yielded similar results in this study.Key Points • Diffusion-weighted MRI aids the identification of non-gadolinium-enhancing malignant gliomas • ADC measurements may permit non-gadolinium-enhancing glioma molecular subtyping • IDH wild-type gliomas have lower ADC values than IDH-mutant tumours • Single cross-section and volumetric ADC measurements yielded comparable results in this study

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“…Low diffusivity predicts poor astrocytoma survival independent from WHO grade [38], although no linear relation exists between ADC and glioma prognosis [39]. …”

Section: Discussionmentioning

confidence: 99%

Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis

et al. 2018

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“…[4][5][6][7][8][9] In contradistinction, there is no definitive consensus on the ability of fractional anisotropy to assess tumor grade, cellular density, and parenchymal infiltration or to prognosticate patient survival. 7,[10][11][12][13][14][15][16][17][18][19][20][21] We performed a quantitative meta-analysis of the existing literature to determine the statistical consensus of mean diffusivity and fractional anisotropy in distinguishing tumor grade of gliomas, separately examining the identifiable tumor core and region of peripheral signal abnormality.…”

mentioning

confidence: 99%

Meta-Analysis of Diffusion Metrics for the Prediction of Tumor Grade in Gliomas

Miloushev

Chow

Filippi

2014

AJNR Am J Neuroradiol

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“…An increase in ADC values reflects decrease in cellularity [48], which is a surrogate for therapy response in glioma [49]. Low ADC values are associated with a poor prognosis [50]. The potential of DWI for integration in target volume definition is furthermore reflected by the fact that it is already in clinical use in radiotherapy of prostate [51,52] or rectal cancer [53], among others [45].…”

Section: Advances In Mr Imaging For Radiation Oncology Treatment Planmentioning

confidence: 99%

PET/MRI and brain tumors: focus on radiation oncology treatment planning

Oehlke

Grosu

2016

Clin Transl Imaging

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In brain tumors, imaging by magnetic resonance imaging (MRI) can very accurately visualize anatomy and morphology of healthy and malignant tissue, but neither contrast-enhancing areas in T1-weighted sequences, nor hyperintensities in T2/FLAIR sequences are specific for tumor tissue, especially when considering the manifold alterations resulting from previous treatment. Imaging the biology of tumor tissue by positron emission tomography (PET), therefore, is a highly interesting approach to improve the detection of macroscopic tumor which is the prerequisite for high-precision radiotherapy treatment planning. This review will focus on the benefits of amino acid tracers (L-[methyl-11 C]methionine (MET) and O-(2-[ 18 F]fluoroethyl)-L-tyrosine (FET)) in neurooncology and their implementation in radiation oncology. Furthermore, a brief overview of the current impact of 2-deoxy-2-(18F)fluoro-D-glucose (FDG), nucleic acid analogs, hypoxia tracers, and Somatostatin receptor (SSTR) analogs on radiotherapy planning in brain tumors is provided. Among advances in multiparametric MRI, Diffusionweighted imaging (DWI) has attracted particular attention since it can predict prognosis, as well as indicate response to treatment and has already been introduced into target volume definition for radiotherapy of various cancers (e.g., prostate and rectal cancer). Additionally, advances in MR spectroscopy (MRS) are mentioned. Finally, these findings will be discussed concerning their influence on current aspects of integrated PET/MR hybrid imaging.

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ADC Values and Prognosis of Malignant Astrocytomas: Does Lower ADC Predict a Worse Prognosis Independent of Grade of Tumor?—A Meta-Analysis

Abstract: Low ADC values correlate with poor survival in malignant astrocytomas independent of tumor grade.

Cited by 71 publications

References 19 publications

Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis

Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis

Meta-Analysis of Diffusion Metrics for the Prediction of Tumor Grade in Gliomas

PET/MRI and brain tumors: focus on radiation oncology treatment planning

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