scholarly journals Apparent diffusion coefficient as a valuable quantitative parameter for predicting clinical outcomes in patients with newly diagnosed primary CNS lymphoma

2020 ◽  
Vol 55 (2) ◽  
pp. 99-106
Author(s):  
Dong Won Baek ◽  
Hee Jeong Cho ◽  
Jae Heung Bae ◽  
Sang Kyun Sohn ◽  
Joon Ho Moon
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Clinical Outcomes ◽  
Primary Cns Lymphoma ◽  
Cns Lymphoma ◽  
Newly Diagnosed ◽  
Quantitative Parameter ◽  
Apparent Diffusion

Apparent diffusion coefficient as a valuable quantitative parameter for predicting clinical outcomes in patients with newly diagnosed primary CNS lymphoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14532-e14532
Author(s):  
Dong Won Baek ◽  
Soo Jung Lee ◽  
Byung Woog Kang ◽  
Joon Ho Moon ◽  
Jong Gwang Kim ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Group Performance ◽  
Cns Lymphoma ◽  
Newly Diagnosed ◽  
Term Survival ◽  
Apparent Diffusion ◽  
Ecog Ps

e14532 Background: Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin lymphoma (NHL). Although, there are various treatment options for PCNSL which include methotrexate based chemotherapy and whole brain radiotherapy (WBRT), half of the patients who initially achieved complete response experience disease relapse. Accordingly, we attempted to identify novel prognostic factors using MRI in patients with newly diagnosed PCNSL. Methods: We retrospectively evaluated 672 patients who were diagnosed with central nervous system (CNS) cancers between January 2011 and May 2018. Enrollment criteria were i) pathologic diagnosis of CNS lymphoma, ii) no evidence of systemic involvement, iii) no evidence of human immunodeficiency virus-1 infection or other immunodeficiencies, and iv) available magnetic resonance imaging (MRI) examinations at diagnosis. Fifty-two patients met these criteria and were enrolled. Results: Patients with low apparent diffusion coefficient (ADC) showed inferior overall survival (OS) compared to those with high ADC. Patients with a hyperintense signal on T2-weighted image and homogenous enhancement showed better failure-free survival (FFS), while patients with low ADC and necrosis showed poor FFS. In the multivariate survival analysis, old age ( > 60) (hazard ratio (HR) 20.372, p= 0.001), Eastern Cooperative Oncology Group performance status ((ECOG PS) ≥ 2 (HR 10.429, p < 0.001), higher levels of lactate dehydrogenase (LDH) (HR 7.408, p= 0.001), and low ADC (HR 0.273, p= 0.009) were associated with inferior OS, while ECOG PS ≥ 2 (HR 10.319, p= 0.021), presence of necrosis (HR 6.372, p= 0.008), and low ADC (HR 0.226, p= 0.020) were unfavorable factors for FFS. Conclusions: We conclude that ADC, a characteristic MRI finding, had significant prognostic value for long-term survival in our study of patients with newly diagnosed PCNSL Specifically, low ADC was an independent unfavorable prognostic factor, suggesting that ADC measurements through non-invasive MRI can improve the current prognostic scoring system.

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 (&lt; 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.

scholarly journals Apparent diffusion coefficient and fractional anisotropy of newly diagnosed grade II gliomas

2009 ◽  
Vol 22 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Inas S. Khayal ◽  
Tracy R. McKnight ◽  
Colleen McGue ◽  
Scott Vandenberg ◽  
Kathleen R. Lamborn ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Fractional Anisotropy ◽  
Newly Diagnosed ◽  
Apparent Diffusion ◽  
Grade Ii
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