Chenevert Thomas L, Malyarenko Dariya I, Galbán Craig J, Gomez-Hassan Diana M, Sundgren Pia C, Tsien Christina I, Ross Brian D
Department of Radiology, University of Michigan Medical School, Ann Arbor, MI.
Department of Clinical Sciences/Radiology Lund University, Lund, Sweden; and.
Tomography. 2019 Mar;5(1):7-14. doi: 10.18383/j.tom.2018.00049.
Noninvasive imaging methods are sought to objectively predict early response to therapy for high-grade glioma tumors. Quantitative metrics derived from diffusion-weighted imaging, such as apparent diffusion coefficient (ADC), have previously shown promise when used in combination with voxel-based analysis reflecting regional changes. The functional diffusion mapping (fDM) metric is hypothesized to be associated with volume of tumor exhibiting an increasing ADC owing to effective therapeutic action. In this work, the reference fDM-predicted survival (from previous study) for 3 weeks from treatment initiation (midtreatment) is compared to multiple histogram-based metrics using Kaplan-Meier estimator for 80 glioma patients stratified to responders and nonresponders based on the population median value for the given metric. The ADC histogram metric reflecting reduction in midtreatment volume of solid tumor (ADC < 1.25 × 10 mm/s) by >8% population-median with respect to pretreatment is found to have the same predictive power as the reference fDM of increasing midtreatment ADC volume above 4%. This study establishes the level of correlation between fDM increase and low-ADC tumor volume shrinkage for prediction of early response to radiation therapy in patients with glioma malignancies.
人们一直在寻找非侵入性成像方法，以客观地预测高级别胶质瘤肿瘤对治疗的早期反应。以前，当基于体素的分析反映区域变化时，从扩散加权成像得出的定量指标，如表观扩散系数（ADC），已显示出前景。功能扩散映射（fDM）指标被假定与因有效治疗作用而表现出ADC增加的肿瘤体积相关。在这项工作中，使用Kaplan-Meier估计器，将80例胶质瘤患者（根据给定指标的总体中位数分为反应者和无反应者）从治疗开始（治疗中期）起3周的参考fDM预测生存率（来自先前研究）与多个基于直方图的指标进行比较。发现反映实体瘤治疗中期体积（ADC < 1.25 × 10 mm/s）相对于预处理减少超过8%总体中位数的ADC直方图指标，与治疗中期ADC体积增加超过4%的参考fDM具有相同的预测能力。这项研究确定了fDM增加与低ADC肿瘤体积缩小之间的相关程度，用于预测胶质瘤恶性肿瘤患者对放射治疗的早期反应。
