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- Title
Intravoxel Incoherent Motion Metrics as Potential Biomarkers for Survival in Glioblastoma.
- Authors
Puig, Josep; Sánchez-González, Javier; Blasco, Gerard; Daunis-i-Estadella, Pepus; Federau, Christian; Alberich-Bayarri, Ángel; Biarnes, Carles; Nael, Kambiz; Essig, Marco; Jain, Rajan; Wintermark, Max; Pedraza, Salvador
- Abstract
Objective: Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma. Methods: Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses. Results: We found that fCER and D*CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D*CER>21.712 x10−3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162–25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy. Conclusions: The IVIM-metrics fCER and D*CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.
- Subjects
GLIOBLASTOMA multiforme; BIOMARKERS; MAGNETIC resonance imaging; BRAIN tumors; KAPLAN-Meier estimator
- Publication
PLoS ONE, 2016, Vol 11, Issue 7, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0158887