Apparent Diffusion Coefficient to Evaluate Adult Intracranial Ependymomas: Relationship to Ki‐67 Proliferation Index

Liu, Xianwang; Han, Lei; Luan, Hong; Deng, Juan; Li, Shenglin; Xue, Caiqiang; Yan, Hao; Zhou, Junlin

doi:10.1111/jon.12789

Cited by 17 publications

(8 citation statements)

References 17 publications

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“…Previous studies reported ADC values could effectively evaluate the grades, proliferation activity, and tumor cell density of glioma [ 40 , 41 ]. In this study, ADC min , ADC mean , rADC min , and rADC mean are all negatively related to Ki-67 LI, which is consistent with prior studies [ 19 , 20 ]. In addition, among the four indicators, rADC min has the highest predictive efficiency on the Ki-67 index level, with an AUROC of 0.778.…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, there could be potential correlations between ADC values and Ki-67 LI. Prior studies have reported that the ADC values of glioma are negatively correlated with Ki-67 LI [ 19 , 20 ]. However, due to the heterogeneity of glioma, especially glioblastoma, the ADC values within glioma are uneven, so it is necessary to standardize the ADC values within the tumor to obtain more reliable results.…”

Section: Introductionmentioning

confidence: 99%

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An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma

Shu

et al. 2023

J Transl Med

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Background and purpose Ki-67 labeling index (LI) is an important indicator of tumor cell proliferation in glioma, which can only be obtained by postoperative biopsy at present. This study aimed to explore the correlation between Ki-67 LI and apparent diffusion coefficient (ADC) parameters and to predict the level of Ki-67 LI noninvasively before surgery by multiple MRI characteristics. Methods Preoperative MRI data of 166 patients with pathologically confirmed glioma in our hospital from 2016 to 2020 were retrospectively analyzed. The cut-off point of Ki-67 LI for glioma grading was defined. The differences in MRI characteristics were compared between the low and high Ki-67 LI groups. The receiver operating characteristic (ROC) curve was used to estimate the accuracy of each ADC parameter in predicting the Ki-67 level, and finally a multivariate logistic regression model was constructed based on the results of ROC analysis. Results ADCmin, ADCmean, rADCmin, rADCmean and Ki-67 LI showed a negative correlation (r = − 0.478, r = − 0.369, r = − 0.488, r = − 0.388, all P < 0.001). The Ki-67 LI of low-grade gliomas (LGGs) was different from that of high-grade gliomas (HGGs), and the cut-off point of Ki-67 LI for distinguishing LGGs from HGGs was 9.5%, with an area under the ROC curve (AUROC) of 0.962 (95%CI 0.933–0.990). The ADC parameters in the high Ki-67 group were significantly lower than those in the low Ki-67 group (all P < 0.05). The peritumoral edema (PTE) of gliomas in the high Ki-67 LI group was higher than that in the low Ki-67 LI group (P < 0.05). The AUROC of Ki-67 LI level assessed by the multivariate logistic regression model was 0.800 (95%CI 0.721–0.879). Conclusions There was a negative correlation between ADC parameters and Ki-67 LI, and the multivariate logistic regression model combined with peritumoral edema and ADC parameters could improve the prediction ability of Ki-67 LI.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma

Shu

et al. 2023

J Transl Med

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“…Multiple studies have shown that there is a correlation between the Ki-67 proliferation index of solid tumors and the ADC. Xianwang et al [10]. found a strong negative correlation between the MinADC and the Ki-67 proliferation index in ependymoma.…”

Section: Discussionmentioning

confidence: 97%

The Relationship Between The Apparent Diffusion Coefficient and The Ki-67 Proliferation Index in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma

Zhou

Zhang

et al. 2021

Preprint

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Objiective: This study evaluated the value of the apparent diffusion coefficient (ADC) in distinguishing grade II and III intracranial solitary fibrous tumors /hemangiopericytomas and explored the correlation between ADC and Ki-67. Methods The preoperative MRIs of 37 patients treated for solitary fibrous tumor/hemangiopericytoma (grade II, n = 15 and grade III, n = 22) in our hospital from 2011 to October 2020 were retrospectively analyzed. We compared the difference between the minimum, average, maximum, and relative ADCs based on tumor grade and examined the correlation between ADC and Ki-67. Receiver operating characteristic curve analysis was used to analyze the diagnostic efficiency of the ADC. Results There were significant differences in the average, minimum, and relative ADCs between grade II and III patients. The optimal cutoff value for the relative ADC value to differentiate grade II and III tumors was 0.998, which yielded an area under the curve of 0.879. The Ki-67 proliferation indexes of grade II and III tumors were significantly different, and the average (r = -0.427), minimum (r = -0.356), and relative (r = -0.529) ADCs were significantly negatively correlated with the Ki-67 proliferation index. Conclusions ADC can be used to differentiate grade II and III intracranial solitary fibrous tumors/hemangiopericytomas. Our results can be used to formulate a personalized surgical treatment plan before surgery.

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“…27,28 The region showing the minimum ADC may reflect the area with highest proliferation within the tumor, and the region showing the maximum ADC may reflect the area with lowest proliferation composed of stroma. 29 Here, we found that higher ADCdiff was associated with greater risk of Ki67 discordance, and that it was independently associated with discordance. ADCdiff has been proposed as a quantitative marker for intra-tumoral heterogeneity.…”

Section: Discussionmentioning

confidence: 50%

“…One of the features from such imaging is ADC, which correlates negatively with tumor cell density and has been shown to correlate negatively with Ki67 expression in breast cancer 27,28 . The region showing the minimum ADC may reflect the area with highest proliferation within the tumor, and the region showing the maximum ADC may reflect the area with lowest proliferation composed of stroma 29 . Here, we found that higher ADCdiff was associated with greater risk of Ki67 discordance, and that it was independently associated with discordance.…”

Section: Discussionmentioning

confidence: 99%

Breast Magnetic Resonance Imaging Can Predict Ki67 Discordance Between Core Needle Biopsy and Surgical Samples

Wei

Tao

et al. 2022

Magnetic Resonance Imaging

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Background: Disagreement in assessments of Ki67 expression based on core-needle biopsy and matched surgical samples complicates decisions in the treatment of breast cancer. Purpose: To examine whether preoperative breast MRI could be useful in predicting Ki67 discordance between core-needle biopsy and surgical samples. Study Type: Retrospective. Population: Three hundred and sixty-five breast cancer patients with MRI scans and having both core-needle biopsy and surgical samples from 2017 to 2019. Field Strength/Sequence: 3.0 T, T2-weighted iterative decomposition of water and fat with echo asymmetry and least squares estimation sequence, diffusion-weighted sequence using b-values 0/1000, dynamic contrast enhanced image by volume imaged breast assessme NT. Assessment: We collected clinicopathologic variables and preoperative MRI features (tumor size, lesion type, shape of mass, spiculated margin, internal enhancement, peri-tumoral edema, intra-tumoral necrosis, multifocal/multicentric, apparent diffusion coefficient [ADC] minimum, ADC mean, ADC maximum, ADC difference). Statistical Tests: K-means clustering, multivariable logistic regression, receiver operating characteristic curve. Results: Sixty-one patients showed Ki67 discordance and 304 patients show Ki67 concordance according to our definition using K-means clustering. Multivariable regression analysis showed that the following parameters were independently associated with Ki67 discordance: peri-tumoral edema, odds ratio (OR) 2.662, 95% confidence interval (CI) 1.432-4.948; ADCmin ≤ 0.829 Â 10 À3 mm 2 /sec, OR 2.180, 95% CI 1.075-4.418; and ADCdiff > 0.317 Â 10 À3 mm 2 /sec, OR 3.365, 95% CI 1.698-6.669. This multivariable model resulted in an AUC of 0.758 (95% CI 0.711-0.802) with sensitivity and specificity being 0.803 and 0.621, respectively. Conclusion: Presence of peri-tumoral edema, smaller ADCmin and greater ADCdiff in preoperative breast MRI may indicate high risk of Ki67 discordance between core-needle biopsy and surgical samples. For patients with these MRI-based risk factors, clinicians should not rely on Ki67 assessment only from core-needle biopsy.

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Apparent Diffusion Coefficient to Evaluate Adult Intracranial Ependymomas: Relationship to Ki‐67 Proliferation Index

Cited by 17 publications

References 17 publications

An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma

An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma

The Relationship Between The Apparent Diffusion Coefficient and The Ki-67 Proliferation Index in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma

Breast Magnetic Resonance Imaging Can Predict Ki67 Discordance Between Core Needle Biopsy and Surgical Samples

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