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Apparent diffusion coefficient parametric response mapping MRI for follow-up of glioblastoma

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Abstract

Objectives

To determine the diagnostic superiority of parametric response mapping of apparent diffusion coefficient (ADCPR) for predicting glioblastoma treatment response, compared to single time point measurement.

Methods

Fifty post-treatment glioblastoma patients were enrolled. ADCPR was calculated from serial apparent diffusion coefficient (ADC) maps acquired before and at the time of first detection of an enlarged contrast-enhancing lesion on voxel-by-voxel basis. The percentage-decrease in ADCPR and tenth percentile histogram cutoff value of ADC (ADC10) were compared at subsequent 3-month and 1-year follow-ups.

Results

The percentage-decrease in ADCPR was significantly higher in the progression group (mean = 33.2–38.3 %) than in the stable-response group (mean = 9.7 %) at 3 months follow-up (corrected p < 0.001 for both readers). ADCPR significantly improved area under the receiver operating characteristic curve from 0.67 to 0.88 (corrected p = 0.037) and from 0.70 to 0.92 (corrected p = 0.020) for both readers, respectively, compared to ADC10 at 3-month follow-up, but did not significantly improve at 1-year follow-up. The inter-reader agreement was higher for ADCPR than ADC10 (intraclass correlation coefficient, 0.93 versus 0.86).

Conclusion

Voxel-based ADCPR appears to be a superior imaging biomarker than ADC, particularly for predicting early tumour progression in patients with glioblastoma.

Key points

• Treatment response pattern of glioblastoma was evaluated using voxel-based ADCPR and ADC10.

• Voxel-based ADCPR was more accurate in predicting treatment response pattern than ADC10.

• Inter-reader agreement was higher in ADCPR calculation than in ADC10 calculation.

• Voxel-based ADCPR can be a predictor of early treatment response pattern for glioblastoma.

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Abbreviations

CCRT:

Concurrent chemoradiotherapy

GBM:

Glioblastoma

ROC:

Receiver operating characteristic

AUC:

Area under the ROC curve

DWI:

Diffusion-weighted imaging

ADC:

Apparent diffusion coefficient

ADCPR:

Parametric response mapping of apparent diffusion coefficient

ADC10 :

10th percentile cutoff of value of apparent diffusion coefficient

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Acknowledgments

The scientific guarantor of this publication is Prof. Sang Joon Kim. The authors state that this work has not received any funding. The Institutional Review Board approved our study (The Institutional Review Board of Asan Medical Center [http://eirb.amc.seoul.kr]: S2014-0072-0002). Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution. The authors thank the Biomedical Imaging Infrastructure, Department of Radiology, Asan Medical Center for the technical support of image processing, and Prof. Hwa Jung Kim for the statistical support and valuable contributions.No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Catholic Kwandong University International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, 25, Simgok-ro 100 beon-gil, Seo-gu, Incheon, 404-834, Republic of Korea

    Ra Gyoung Yoon

  2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Ho Sung Kim, Gil Sun Hong & Sang Joon Kim

  3. Department of Radiology, Bundang Jesaeng Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, Republic of Korea

    Dae Yoon Kim

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  1. Ra Gyoung Yoon
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  2. Ho Sung Kim
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Correspondence to Ho Sung Kim.

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Yoon, R.G., Kim, H.S., Kim, D.Y. et al. Apparent diffusion coefficient parametric response mapping MRI for follow-up of glioblastoma. Eur Radiol 26, 1037–1047 (2016). https://doi.org/10.1007/s00330-015-3896-8

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  • DOI: https://doi.org/10.1007/s00330-015-3896-8

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