Department of radiology, MT Kassab institute of orthopaedics, Tunis, Tunisia.
Faculty of medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia.
Tunis Med. 2024 Feb 5;102(2):94-99. doi: 10.62438/tunismed.v102i2.4746.
Although glioblastoma (GBM) has a very poor prognosis, overall survival (OS) in treated patients shows great difference varying from few days to several months. Identifying factors explaining this difference would improve management of patient treatment.
To determine the relevance of diffusion restriction in newly diagnosed treatment-naïve GBM patients.
Preoperative magnetic resonance scans of 33 patients with GBM were reviewed. Regions of interest including all the T2 hyperintense lesion were drawn on diffusion weighted B0 images and transferred to the apparent diffusion coefficient (ADC) map. For each patient, a histogram displaying the ADC values within in the regions of interest was generated. Volumetric parameters including tumor regions with restricted diffusion, parameters derived from histogram and mean ADC value of the tumor were calculated. Their relationship with OS was analyzed.
Patients with mean ADC value < 1415x10-6 mm2/s had a significantly shorter OS (p=0.021). Among volumetric parameters, the percentage of volume within T2 lesion with a normalized ADC value <1.5 times that in white matter was significantly associated with OS (p=0.0045). Patients with a percentage>23.92% had a shorter OS. Among parameters derived from histogram, the 50th percentile showed a trend towards significance for OS (p=0.055) with patients living longer when having higher values of 50th percentile. A difference in OS was observed between patients according to ADC peak of histogram but this difference did not reach statistical significance (p=0.0959).
Diffusion magnetic resonance imaging may provide useful information for predicting GBM prognosis.
尽管胶质母细胞瘤（GBM）的预后非常差，但接受治疗的患者的总生存期（OS）差异很大，从数天到数月不等。确定解释这种差异的因素将有助于改善患者治疗管理。
确定新诊断的未经治疗的 GBM 患者弥散受限的相关性。
回顾了 33 例 GBM 患者的术前磁共振扫描。在弥散加权 B0 图像上绘制包括所有 T2 高信号病变的感兴趣区域，并将其转移到表观弥散系数（ADC）图上。为每位患者生成显示感兴趣区域内 ADC 值的直方图。计算包括弥散受限肿瘤区域在内的容积参数、从直方图得出的参数和肿瘤的平均 ADC 值。并分析它们与 OS 的关系。
平均 ADC 值<1415x10-6 mm2/s 的患者 OS 明显缩短（p=0.021）。在容积参数中，T2 病变内归一化 ADC 值<1.5 倍白质的体积百分比与 OS 显著相关（p=0.0045）。百分比>23.92%的患者 OS 更短。在从直方图得出的参数中，50%分位数与 OS 有显著趋势（p=0.055），50%分位数较高的患者生存期更长。根据直方图的 ADC 峰值观察到患者之间 OS 存在差异，但差异没有达到统计学意义（p=0.0959）。
弥散磁共振成像可能为预测 GBM 预后提供有用信息。
