%0 Journal Article
%T Apparent diffusion coefficient and tumor volume measurements help stratify progression
%A Alessandra Trisoglio
%A Alessandro Carriero
%A Alessandro Stecco
%A Andrea P Sponghini
%A Bruno Del Sette
%A Eleonora Soligo
%A Francesco Buemi
%A Giuseppe Guzzardi
%A Roberta Matheoud
%J The Neuroradiology Journal
%@ 2385-1996
%D 2019
%R 10.1177/1971400919847184
%X The aim of this study was to determine whether apparent diffusion coefficient (ADC) bi-component curve-fitting histogram analysis and volume percentage change (VPC) prior to bevacizumab treatment can stratify progression-free survival (PFS) and overall survival (OS) in patients with glioblastoma multiforme (GBM) on first recurrence. We retrospectively evaluated 17 patients with recurrent GBM who received bevacizumab and fotemustine (n£¿=£¿13) or only bevacizumab (n£¿=£¿4) on first recurrence at our institution between December 2009 and July 2015. Both T2/FLAIR abnormalities and enhancing tumor on T1 images were mapped to the ADC images. ADC-L and ADC-M values were obtained trough bi-Gaussian curve fitting histogram analysis. Furthermore, the study population was dichotomized into two subgroups: patients displaying a reduction in enhancing tumor volume of either >55% or <55% between the mean value calculated at baseline and first follow-up. Subsequently, a second dichotomization was performed according to a reduction in the T2 / FLAIR volume >41% or <41% at first check after treatment. OS and PFS were assessed using volume parameters in a Cox regression model adjusted for significant clinical parameters. In univariate analysis, contrast-enhanced (CE)-ADC-L was significantly predictive of PFS (p£¿=£¿0.01) and OS (p£¿=£¿0.03). When we dichotomized our sample using the 55% cut-off for enhancing tumor volume, CE-VPC was able to predict PFS (p£¿=£¿0.01) but not OS (p£¿=£¿0.08). In multivariate analysis, only the CE-ADC-L was predictive of PFS (p£¿=£¿0.01), albeit not predictive of OS (p£¿=£¿0.14). CE-ADC-M, T2/FLAIR-ADC-L, T2/FLAIR-ADC, and T2/FLAIR VPC were not significantly predictive of PFS and OS (p£¿>£¿0.05) in both univariate and multivariate analysis. CE-ADC and CE-VPC can stratify PFS for patients with recurrent glioblastoma prior to bevacizumab treatment
%K Apparent diffusion coefficient
%K bevacizumab
%K MRI
%K neuroradiology
%U https://journals.sagepub.com/doi/full/10.1177/1971400919847184