Can Apparent Diffusion Coefficient (ADC) maps replace Diffusion Tensor Imaging (DTI) maps to predict the volumetric response of meningiomas to Gamma Knife Radiosurgery?

Abstract

Noninvasive methods are desired to predict the treatment response to Stereotactic Radiosurgery (SRS) to improve individual tumor management. In a previous study, we demonstrated that Diffusion Tensor Imaging (DTI)-derived parameter maps signi cantly correlate to SRS response. This study aimed to analyze and compare the predictive value of intratumoral ADC and DTI parameters in patients with meningiomas undergoing radiosurgery. MethodsMR images of 70 patients treated with Gamma Knife SRS for WHO grade I meningiomas were retrospectively reviewed. MR acquisition included pre-and post-treatment DWI and DTI sequences, and subtractions were calculated to assess for radiation-induced changes in the parameter values. ResultsAfter a mean follow-up period (FUP) of 52.7 months, 69 of 70 meningiomas were controlled, with a mean volume reduction of 34.9%. Whereas fractional anisotropy (FA) values of the initial exam showed the highest correlation to tumor volume change at the last FU (CC=-0.607), followed by the differences between rst and second FU values of FA (CC=-0.404) and the rst longitudinal diffusivity (LD) value (CC=-0.375), the correlation coe cients of all ADC values were comparably low. Nevertheless, all these correlations, except for ADC measured at the rst follow-up, reached signi cance. ConclusionFor the rst time, the prognostic value of ADC maps measured in meningiomas before and at rst followup after Gamma Knife SRS, was compared to simultaneously acquired DTI parameter maps. Quantities assessed from ADC maps present signi cant correlations to the volumetric meningioma response but are less effective than correlations with DTI parameters.