Intravoxel Incoherent Motion Metrics as Potential Biomarkers for Survival in Glioblastoma

Autores de IIS La Fe

• Ángel Alberich Bayarri

  Autor

Participantes ajenos a IIS La Fe

• Puig J
• Sanchez-Gonzalez J
• Blasco G
• Daunis-I-Estadella P
• Federau C
• Biarnes C
• Nael K
• Essig M
• Jain R
• Wintermark M
• Pedraza S

Grupos

• Investigacion Biomédica en Imagen (GIBI 2-30)

  Investigador Principal

  Leonor Cerdá Alberich

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/mm(2). 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 f(CER) and D*(CER) correlated with rCBF(CER). The best cutoffs for 6-month survival were f(CER)>9.86% and D*(CER)>21.712 x 10(-3)mm(2)/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); f(CER) combined with treatment predicted survival with 100% accuracy. Conclusions The IVIM-metrics f(CER) and D*(CER) are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.