Graduate School of Health Sciences, Kumamoto University, Kuhonji 4-24-1, Kumamoto 860-0976, Japan.
Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kuhonji 4-24-1, 860-0976 Kumamoto, Japan.
J Neuroradiol. 2018 Jul;45(4):236-241. doi: 10.1016/j.neurad.2017.11.011. Epub 2017 Dec 21.
To investigate the potential to predict prognosis of glioblastoma (GBM) patients by analysis of the broader and lower values in the lower distribution of apparent diffusion coefficient (ADC) (B&L-ADC) values in the ADC histogram.
Presurgical publicly available diffusion-weighted images (DWI) and contrast-enhanced T1-weighted images from 76 GBM patients were analyzed. With applied 2-mixture normal distribution in the ADC histogram of enhanced lesions on T1-weighted images, the mean and width of ADC were analyzed. We dichotomized the lower mean of ADC (L-ADC) and the broader width of ADC (B-ADC) at their own average. B&L-ADC was defined as B-ADC with L-ADC. Progression-free survival (PFS) and overall survival (OS) were determined by using Cox proportional hazards analysis and the Kaplan-Meier method with the log-rank test. The difference between PFS and OS was calculated.
Six (7.89%) patients had B&L-ADC values. B&L-ADC was strongly associated with poor PFS (hazard risk: 5.747; P=0.002) and OS (hazard risk: 3.331; P=0.018). There were significant differences in PFS (median, 77 vs. 302 days; P<0.001) and OS (median, 199 vs. 472 days; P=0.004) between the patents with and without B&L-ADC. There was no significant difference in the OS-PFS duration difference between the patients with (median, 79 days) and without B&L-ADC (median, 132 days) (P=0.348).
In this study, B&L-ADC from pretreatment ADC analysis predicted poor PFS. B&L-ADC may indicate higher cellularity and heterogeneity in GBM tumor tissue.
通过分析表观扩散系数（ADC）直方图中较低分布的较宽和较低值（B&L-ADC）值，来探讨预测胶质母细胞瘤（GBM）患者预后的潜力。
分析了 76 名 GBM 患者术前可公开获得的弥散加权成像（DWI）和增强 T1 加权图像。在 T1 加权图像上的增强病变的 ADC 直方图中应用 2-混合正态分布，分析 ADC 的平均值和宽度。我们将 ADC 的较低平均值（L-ADC）和较宽的 ADC 宽度（B-ADC）分别在各自的平均值处进行二分。B&L-ADC 定义为 B-ADC 与 L-ADC 的组合。使用 Cox 比例风险分析和 Kaplan-Meier 方法结合对数秩检验确定无进展生存期（PFS）和总生存期（OS）。计算 PFS 和 OS 之间的差异。
有 6 名（7.89%）患者的 B&L-ADC 值。B&L-ADC 与较差的 PFS（风险比：5.747；P=0.002）和 OS（风险比：3.331；P=0.018）强烈相关。有和没有 B&L-ADC 的患者在 PFS（中位数，77 与 302 天；P<0.001）和 OS（中位数，199 与 472 天；P=0.004）方面存在显著差异。有和没有 B&L-ADC 的患者的 OS-PFS 持续时间差异无统计学意义（中位数，79 天与 132 天；P=0.348）。
在本研究中，治疗前 ADC 分析的 B&L-ADC 预测了较差的 PFS。B&L-ADC 可能表明 GBM 肿瘤组织中细胞密度和异质性更高。
