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Infiltrative patterns of glioblastoma: Identification of tumor progress using apparent diffusion coefficient histograms
Author(s) -
Lutz Kira,
Wiestler Benedikt,
Graf Markus,
Bäumer Philipp,
Floca Ralf,
Schlemmer HeinzPeter,
Heiland Sabine,
Wick Wolfgang,
Bendszus Martin,
Radbruch Alexander
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24258
Subject(s) - effective diffusion coefficient , medicine , fluid attenuated inversion recovery , histogram , nuclear medicine , glioblastoma , diffusion mri , radiology , magnetic resonance imaging , cancer research , artificial intelligence , computer science , image (mathematics)
Purpose To investigate whether apparent diffusion coefficient (ADC) histogram analysis can differentiate between patients presenting T2‐progress and patients presenting stable T2‐signal in glioblastoma. Materials and Methods Fourteen patients presenting an isolated T2‐progress and a matched control group exhibiting stable disease were included. Relative ADC value distribution within tumoral and peritumoral FLAIR hyperintensities were evaluated using ADC‐histogram analysis. Severity and frequency of ADC shift between baseline, T2‐progress, and subsequent T1‐progress were analyzed using the Wilcoxon test. Results The shift of ADC histograms either to higher or to lower values in case of T2‐progress was significantly more severe than in the control group ( P value 0.05). Furthermore, a significant shift toward lower ADC values ( P value 0.02) was detected when comparing ADC histograms of patients with T2‐progress and subsequent T1‐progress. Conclusion The basis for the observed ADC shift in isolated T2‐progress may be time dependent: Initially, formation of peritumoral edema may cause an increase of ADC values that is followed by tumor cells infiltrating the surrounding tissue, causing a subsequent decrease of ADC values. The shift toward lower ADC values in case of subsequent T1‐progress confirms this hypothesis and provides further evidence for T2‐progress being an intermediate step between stable disease (SD) and T1‐progress. J. Magn. Reson. Imaging 2014;39:1096–1103 . © 2013 Wiley Periodicals, Inc .