Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in Patients with Glioblastoma.

Abstract:

BACKGROUND:Although targeted by radiotherapy, recurrence in glioblastoma occurs mainly periresectionally owing to tumor infiltration. An increase in the apparent diffusion coefficient (ADC) has been shown in the large high-T2 area on magnetic resonance imaging posttreatment; however, until now ADC has not been investigated directly in the more relevant periresectional area. METHODS:Histogram analysis was used to assess periresectional ADC values in patients with glioblastoma postradiotherapy versus preradiotherapy. Periresectional ADC values starting at 0-5 mm in 5-mm increments up to 20-25 mm were extracted and compared using 2-way repeated-measurements analysis of variance. RESULTS:Mean ADC values directly adjacent to the resection area (0-5 mm) were significantly higher postradiotherapy compared with preradiotherapy (P = .017). ADC values in the 0- to 5-mm region were also higher than those in 5- to 10-, 10- to 15-, and 15- to 20-mm regions (P < .05). Regional standard deviations in ADC values were higher postradiotherapy compared with preradiotherapy for the 0- to 5-mm region up to the 15- to 20-mm region, inclusive (P < .05); however, Cox regression analysis showed no survival benefits from the increased ADC in the 0- to 5-mm region postradiotherapy. CONCLUSIONS:Increased ADC values, representing a decrease in infiltrative tumor load, were demonstrated in a limited direct periresectional area. This finding adds to previous studies evaluating ADC response in the larger high-T2 area in relation to survival.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

van der Hoorn A,Yan JL,Larkin TJ,Boonzaier NR,Matys T,Price SJ

doi

10.1016/j.wneu.2016.04.129

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

159-165

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(16)30258-3

journal_volume

92

pub_type

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