scholarly journals Distinguishing Recurrent Primary Brain Tumor from Radiation Injury: A Preliminary Study Using a Susceptibility-Weighted MR Imaging−Guided Apparent Diffusion Coefficient Analysis Strategy

2010 ◽  
Vol 31 (6) ◽  
pp. 1049-1054 ◽  
Author(s):  
A. Al Sayyari ◽  
R. Buckley ◽  
C. McHenery ◽  
K. Pannek ◽  
A. Coulthard ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Brain Tumor ◽  
Mr Imaging ◽  
Apparent Diffusion Coefficient ◽  
Radiation Injury ◽  
Primary Brain Tumor ◽  
Apparent Diffusion ◽  
Analysis Strategy ◽  
Preliminary Study

scholarly journals BIOM-53. DIFFUSION MR IMAGING DERIVED APPARENT DIFFUSION COEFFICIENT AS A POTENTIAL BIOMARKER OF CLINICAL OUTCOME IN RECURRENT CENTRAL NERVOUS SYSTEM LYMPHOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii13-ii13
Author(s):  
Ka-wai Ho ◽  
Anton Nosov ◽  
Robert Young ◽  
Christian Grommes
Keyword(s):  
Diffusion Coefficient ◽  
Mr Imaging ◽  
Apparent Diffusion Coefficient ◽  
Cell Count ◽  
Prognostic Value ◽  
Single Agent ◽  
Cns Lymphoma ◽  
High Quality ◽  
Potential Biomarker ◽  
Apparent Diffusion

Abstract BACKGROUND Studies have shown that diffusion-weighted imaging (DWI) derived apparent diffusion coefficient (ADC) measurements inversely correlate with tumor cell density and may have prognostic value in newly-diagnosed CNS lymphoma patients. This study characterizes ADC measurements in a relapsed/refractory CNS lymphoma population and describes the potential prognostic value of ADC measurements in these patients. METHODS ADC measurements were assessed in immunocompetent patients enrolled on a prospective clinical trial studying ibrutinib-based treatment in recurrent/refractory CNS lymphoma (NCT02315326; 42 treated with single agent ibrutinib and 15 with an ibrutinib containing combination). Measurements were normalized to values contralateral to the lesion to generate an ADC measurement ratio. Imaging and clinical variables were correlated with treatment response. High-quality lesions were defined as areas with clear delineation from preserved brain parenchyma ≥ 10mm in maximal transverse dimension. Cerebral spinal fluid (CSF) was collected at time of MR imaging in all patients. RESULTS Thirty-nine out of 57 patients had lesions with measurable ADC of which 17 (44%) were high-quality ADC lesions. The median ADCmean ratio was 0.909 (range 0.497–1.444). There was no association between ADC ratios and tumor volume, CSF cell count, or CSF protein. The high-quality lesions had a median ADCmean ratio of 0.774 (range 0.497–1.051). These patients with a high ADCmean ratio (≥ 0.774) had increased rates of partial and complete responses (p=0.057) as well as a longer progression free survival (PFS; median not reached) compared to those with low ADCmean ratios (< 0.774; median PFS=1.5 months, p=0.016). CONCLUSION ADC ratios in the recurrent CNS population do not correlate with tumor size, cell count, or protein in the CSF. In high-quality DWI measurements, ADC might be a prognostic marker in relapsed/refractory CNS lymphoma patients treated with ibrutinib.

Prognostic significance of early changes in the apparent diffusion coefficient that occurs after treatment of patients with glioblastoma multiforme with bevacizumab

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 2058-2058
Author(s):  
M. Paldino ◽  
A. Desjardins ◽  
H. S. Friedman ◽  
J. J. Vredenburgh ◽  
D. P. Barboriak
Keyword(s):  
Diffusion Coefficient ◽  
Glioblastoma Multiforme ◽  
Mr Imaging ◽  
Apparent Diffusion Coefficient ◽  
Diffusion Tensor ◽  
Prognostic Significance ◽  
Single Shot ◽  
Signal Abnormality ◽  
Contrast Enhanced ◽  
Apparent Diffusion

2058 Background: To determine the prognostic significance of changes in parameters derived from diffusion tensor imaging (DTI) that occur in response to combination chemotherapy with the antiangiogenesis agent bevacizumab (BEV) in patients with recurrent glioblastoma multiforme (GBM). Methods: 16 patients (10 men, 6 women; age range 38–62 years) with recurrent GBM underwent serial 1.5T MR imaging. Axial single-shot echo planar DTI (TR/TE 6000/100; flip angle 90 degrees; voxel: 1.72 x 1.72 x 5mm; b value of 1000 sec/mm2; 12 directions) was obtained on scans performed 3 days and 1 day prior to and 1 day after initiation of therapy with BEV and irinotecan (CPT-11). Clinical follow-up and survival status was documented up to 20 months after the date of initial MR imaging. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were aligned to whole brain contrast-enhanced 3D FLASH and 3D FLAIR image volumes (1 mm isotropic voxels) using a rigid body normalized mutual information algorithm. Based on two pre-treatment scans, the 95% confidence limits for change (95%CL) in ADC and FA were calculated in volumes of tumor-related contrast-enhancement (TRE) and FLAIR signal abnormality (FSA). A patient was considered to have a change in FA or ADC after therapy if the difference between the pre- and post-treatment values was greater than the 95% CL for that parameter. Progression was defined on contrast-enhanced MRI using MacDonald criteria by neuro-oncologists blinded to the DTI findings. Survival was compared using the log rank test. Results: DTI detected a change in ADC within FSA after therapy in three patients (2 increased, 1 decreased). Patients with a change in ADC within FSA had significantly shorter overall (p < 0.0012) and progression free (p < 0.015) survival than those with no change. Median survival in the patient group with a change in ADC was 24.7 (95% CI [17.3, 39.4]) weeks and 56.4 (95% CI [41.7, 96]) weeks in those patients with no change. Conclusions: In patients with GBM treated with BEV and CPT-11, a change in ADC after therapy in areas of FSA is associated with decreased survival. Parameters derived from DTI may, therefore, potentially serve as early markers of treatment failure in patients with GBM. [Table: see text]

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