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

van der Hoorn, A; Yan, J-L; Larkin, TJ; Boonzaier, NR; Matys, T; Price, SJ; (2016) Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in Patients with Glioblastoma. World Neurosurgery , 92 pp. 159-165. 10.1016/j.wneu.2016.04.129. Green open access

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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.

Type: Article
Title: Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in Patients with Glioblastoma
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.wneu.2016.04.129
Publisher version: https://doi.org/10.1016/j.wneu.2016.04.129
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Apparent diffusion coefficient, Brain tumor, Glioblastoma, Magnetic resonance imaging, Treatment response
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10060129
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