Relationship between apparent diffusion coefficient and survival as a function of distance from gross tumor volume on radiation planning MRI in newly diagnosed glioblastoma.
Apparent diffusion coefficient
Diffusion weighted imaging
Glioblastoma
Overall survival
Progression free survival
Journal
Journal of neuro-oncology
ISSN: 1573-7373
Titre abrégé: J Neurooncol
Pays: United States
ID NLM: 8309335
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
12
07
2023
accepted:
26
08
2023
medline:
6
11
2023
pubmed:
14
9
2023
entrez:
14
9
2023
Statut:
ppublish
Résumé
To investigate the changes in apparent diffusion coefficient (ADC) within incrementally-increased margins beyond the gross tumor volume (GTV) on post-operative radiation planning MRI and their prognostic utility in glioblastoma. Radiation planning MRIs of adult patients with newly diagnosed glioblastoma from 2017 to 2020 were assessed. The ADC values were normalized to contralateral normal white matter (nADC). Using 1 mm isotropic incremental margin increases from the GTV, the nADC values were calculated at each increment. Age, ECOG performance status, extent of resection and MGMT promoter methylation status were obtained from medical records. Using univariate and multivariable Cox regression analysis, association of nADC to progression-free and overall survival (PFS, OS) was assessed at each increment. Seventy consecutive patients with mean age of 53.6 ± 10.3 years, were evaluated. The MGMT promoter was methylated in 31 (44.3%), unmethylated in 36 (51.6%) and unknown in 3 (4.3%) patients. 11 (16%) underwent biopsy, 41 (44%) subtotal resection and 18 (26%) gross total resection. For each 1 mm increase in distance from GTV, the nADC decreased by 0.16% (p < 0.0001). At 1-5 mm increment, the nADC was associated with OS (p < 0.01). From 6 to 11 mm increment the nADC was associated with OS with the p-value gradually increasing from 0.018 to 0.046. nADC was not associated with PFS. The nADC values at 1-11 mm increments from the GTV margin were associated with OS. Future prospective multicenter studies are needed to validate the findings and to pave the way for the utilization of ADC for margin reduction in radiation planning.
Identifiants
pubmed: 37707752
doi: 10.1007/s11060-023-04440-1
pii: 10.1007/s11060-023-04440-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
597-605Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW (2021) The 2021 WHO classification of tumors of the central nervous System: a summary. Neurooncology 23:1231–1251. https://doi.org/10.1093/neuonc/noab106
doi: 10.1093/neuonc/noab106
McDonald MW, Shu HK, Curran WJ Jr, Crocker IR (2011) Pattern of failure after limited margin radiotherapy and temozolomide for glioblastoma. Int J Radiat Oncol Biol Phys 79:130–136. https://doi.org/10.1016/j.ijrobp.2009.10.048
doi: 10.1016/j.ijrobp.2009.10.048
pubmed: 20399036
Gebhardt BJ, Dobelbower MC, Ennis WH, Bag AK, Markert JM, Fiveash JB (2014) Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide. Radiat Oncol 9:130. https://doi.org/10.1186/1748-717X-9-130
doi: 10.1186/1748-717X-9-130
pubmed: 24906388
pmcid: 4055938
Rapp M, Baernreuther J, Turowski B, Steiger HJ, Sabel M, Kamp MA (2017) Recurrence pattern analysis of primary glioblastoma. World Neurosurg 103:733–740. https://doi.org/10.1016/j.wneu.2017.04.053
doi: 10.1016/j.wneu.2017.04.053
pubmed: 28434963
Tu Z, Xiong H, Qiu Y, Li G, Wang L, Peng S (2021) Limited recurrence distance of glioblastoma under modern radiotherapy era. BMC Cancer 21:720. https://doi.org/10.1186/s12885-021-08467-3
doi: 10.1186/s12885-021-08467-3
pubmed: 34154559
pmcid: 8218451
Dhermain F (2014) Radiotherapy of high-grade gliomas: current standards and new concepts, innovations in imaging and radiotherapy, and new therapeutic approaches. Chin J Cancer 33:16–24. https://doi.org/10.5732/cjc.013.10217
doi: 10.5732/cjc.013.10217
pubmed: 24384237
pmcid: 3905086
Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109–122. https://doi.org/10.1016/0360-3016(91)90171-y
doi: 10.1016/0360-3016(91)90171-y
pubmed: 2032882
Torres IJ, Mundt AJ, Sweeney PJ, Llanes-Macy S, Dunaway L, Castillo M, Macdonald RL (2003) A longitudinal neuropsychological study of partial brain radiation in adults with brain tumors. Neurology 60:1113–1118. https://doi.org/10.1212/01.wnl.0000055862.20003.4a
doi: 10.1212/01.wnl.0000055862.20003.4a
pubmed: 12682316
Kleinberg L, Wallner K, Malkin MG (1993) Good performance status of long-term disease-free survivors of intracranial gliomas. Int J Radiat Oncol Biol Phys 26:129–133. https://doi.org/10.1016/0360-3016(93)90183-v
doi: 10.1016/0360-3016(93)90183-v
pubmed: 8387064
Paulsson AK, McMullen KP, Peiffer AM, Hinson WH, Kearns WT, Johnson AJ, Lesser GJ, Ellis TL, Tatter SB, Debinski W, Shaw EG, Chan MD (2014) Limited margins using modern radiotherapy techniques does not increase marginal failure rate of glioblastoma. Am J Clin Oncol 37:177–181. https://doi.org/10.1097/COC.0b013e318271ae03
doi: 10.1097/COC.0b013e318271ae03
pubmed: 23211224
pmcid: 4485493
Minniti G, Tini P, Giraffa M, Capone L, Raza G, Russo I, Cinelli E, Gentile P, Bozzao A, Paolini S, Esposito V (2023) Feasibility of clinical target volume reduction for glioblastoma treated with standard chemoradiation based on patterns of failure analysis. Radiother Oncol 181:109435. https://doi.org/10.1016/j.radonc.2022.11.024
doi: 10.1016/j.radonc.2022.11.024
pubmed: 36529439
Pollom EL, Fujimoto D, Wynne J, Seiger K, Modlin LA, Jacobs LR, Azoulay M, von Eyben R, Tupper L, Gibbs IC, Hancock SL, Li G, Chang SD, Adler JR, Harsh GR, Harraher C, Nagpal S, Thomas RP, Recht LD, Choi CYH, Soltys SG (2017) Phase 1/2 trial of 5-fraction stereotactic radiosurgery with 5-mm margins with concurrent and adjuvant temozolomide in newly diagnosed supratentorial glioblastoma: health-related quality of life results. Int J Radiat Oncol Biol Phys 98:123–130. https://doi.org/10.1016/j.ijrobp.2017.01.242
doi: 10.1016/j.ijrobp.2017.01.242
pubmed: 28586949
pmcid: 6193756
Niyazi M, Brada M, Chalmers AJ, Combs SE, Erridge SC, Fiorentino A, Grosu AL, Lagerwaard FJ, Minniti G, Mirimanoff RO, Ricardi U, Short SC, Weber DC, Belka C (2016) ESTRO-ACROP guideline target delineation of glioblastomas. Radiother Oncol 118:35–42. https://doi.org/10.1016/j.radonc.2015.12.003
doi: 10.1016/j.radonc.2015.12.003
pubmed: 26777122
Tseng C-L, Stewart J, Whitfield G, Verhoeff JJC, Bovi J, Soliman H, Chung C, Myrehaug S, Campbell M, Atenafu EG, Heyn C, Das S, Perry J, Ruschin M, Sahgal A (2020) Glioma consensus contouring recommendations from a MR-Linac international consortium research group and evaluation of a CT-MRI and MRI-only workflow. J Neurooncol 149:305–314. https://doi.org/10.1007/s11060-020-03605-6
doi: 10.1007/s11060-020-03605-6
pubmed: 32860571
pmcid: 7541359
Wen Q, Jalilian L, Lupo JM, Molinaro AM, Chang SM, Clarke J, Prados M, Nelson SJ (2015) Comparison of ADC metrics and their association with outcome for patients with newly diagnosed glioblastoma being treated with radiation therapy, temozolomide, erlotinib and bevacizumab. J Neurooncol 121:331–339. https://doi.org/10.1007/s11060-014-1636-6
doi: 10.1007/s11060-014-1636-6
pubmed: 25351579
Eidel O, Neumann JO, Burth S, Kieslich PJ, Jungk C, Sahm F, Kickingereder P, Kiening K, Unterberg A, Wick W, Schlemmer HP, Bendszus M, Radbruch A (2016) Automatic analysis of cellularity in glioblastoma and correlation with ADC using trajectory analysis and automatic nuclei counting. PLoS One 11:e0160250. https://doi.org/10.1371/journal.pone.0160250
doi: 10.1371/journal.pone.0160250
pubmed: 27467557
pmcid: 4965093
Gupta A, Young RJ, Karimi S, Sood S, Zhang Z, Mo Q, Gutin PH, Holodny AI, Lassman AB (2011) Isolated diffusion restriction precedes the development of enhancing tumor in a subset of patients with glioblastoma. AJNR Am J Neuroradiol 32:1301–1306. https://doi.org/10.3174/ajnr.A2479
doi: 10.3174/ajnr.A2479
pubmed: 21596805
pmcid: 4040369
Ellingson BM, Bendszus M, Boxerman J, Barboriak D, Erickson BJ, Smits M, Nelson SJ, Gerstner E, Alexander B, Goldmacher G, Wick W, Vogelbaum M, Weller M, Galanis E, Kalpathy-Cramer J, Shankar L, Jacobs P, Pope WB, Yang D, Chung C, Knopp MV, Cha S, van den Bent MJ, Chang S, Al Yung WK, Cloughesy TF, Wen PY, Gilbert MR, Committee tJBTDDCISS, Whitney A, Sandak D, Musella A, Haynes C, Wallace M, Arons DF, Kingston A, Sul J, Krainak D, tJBTDDCISS Committee (2015) Consensus recommendations for a standardized brain tumor imaging protocol in clinical trials. Neurooncology 17:1188–1198. https://doi.org/10.1093/neuonc/nov095
doi: 10.1093/neuonc/nov095
Jabehdar Maralani P, Myrehaug S, Mehrabian H, Chan AKM, Wintermark M, Heyn C, Conklin J, Ellingson BM, Rahimi S, Lau AZ, Tseng CL, Soliman H, Detsky J, Daghighi S, Keith J, Munoz DG, Das S, Atenafu EG, Lipsman N, Perry J, Stanisz G, Sahgal A (2021) Intravoxel incoherent motion (IVIM) modeling of diffusion MRI during chemoradiation predicts therapeutic response in IDH wildtype glioblastoma. Radiother Oncol 156:258–265. https://doi.org/10.1016/j.radonc.2020.12.037
doi: 10.1016/j.radonc.2020.12.037
pubmed: 33418005
Stewart J, Sahgal A, Lee Y, Soliman H, Tseng CL, Detsky J, Husain Z, Ho L, Das S, Maralani PJ, Lipsman N, Stanisz G, Perry J, Chen H, Atenafu EG, Campbell M, Lau AZ, Ruschin M, Myrehaug S (2021) Quantitating Interfraction target dynamics during concurrent chemoradiation for glioblastoma: a prospective serial imaging study. Int J Radiat Oncol Biol Phys 109:736–746. https://doi.org/10.1016/j.ijrobp.2020.10.002
doi: 10.1016/j.ijrobp.2020.10.002
pubmed: 33068687
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1
doi: 10.1007/s00401-016-1545-1
pubmed: 27157931
Sasaki M, Yamada K, Watanabe Y, Matsui M, Ida M, Fujiwara S, Shibata E (2008) Variability in absolute apparent diffusion coefficient values across different platforms may be substantial: a multivendor, multi-institutional comparison study. Radiology 249:624–630. https://doi.org/10.1148/radiol.2492071681
doi: 10.1148/radiol.2492071681
pubmed: 18936317
Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, Degroot J, Wick W, Gilbert MR, Lassman AB, Tsien C, Mikkelsen T, Wong ET, Chamberlain MC, Stupp R, Lamborn KR, Vogelbaum MA, van den Bent MJ, Chang SM (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972. https://doi.org/10.1200/jco.2009.26.3541
doi: 10.1200/jco.2009.26.3541
pubmed: 20231676
Allen LM, Hasso AN, Handwerker J, Farid H (2012) Sequence-specific MR imaging findings that are useful in dating ischemic stroke. Radiographics 32:1285–1297. https://doi.org/10.1148/rg.325115760 . (discussion 1297 – 1289)
doi: 10.1148/rg.325115760
pubmed: 22977018
van der Hoorn A, Yan JL, Larkin TJ, Boonzaier NR, Matys T, Price SJ (2016) Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in patients with Glioblastoma. World Neurosurg 92:159–165. https://doi.org/10.1016/j.wneu.2016.04.129
doi: 10.1016/j.wneu.2016.04.129
pubmed: 27185650
Knopp EA, Cha S, Johnson G, Mazumdar A, Golfinos JG, Zagzag D, Miller DC, Kelly PJ, Kricheff II (1999) Glial neoplasms: dynamic contrast-enhanced T2*-weighted MR imaging. Radiology 211:791–798. https://doi.org/10.1148/radiology.211.3.r99jn46791
doi: 10.1148/radiology.211.3.r99jn46791
pubmed: 10352608
Lee EK, Choi SH, Yun TJ, Kang KM, Kim TM, Lee SH, Park CK, Park SH, Kim IH (2015) Prediction of response to Concurrent Chemoradiotherapy with Temozolomide in Glioblastoma: application of Immediate Post-Operative Dynamic susceptibility contrast and Diffusion-Weighted MR Imaging. Korean J Radiol 16:1341–1348. https://doi.org/10.3348/kjr.2015.16.6.1341
doi: 10.3348/kjr.2015.16.6.1341
pubmed: 26576125
pmcid: 4644757
Vivas-Buitrago T, Domingo RA, Tripathi S, De Biase G, Brown D, Akinduro OO, Ramos-Fresnedo A, Sabsevitz DS, Bendok BR, Sherman W, Parney IF, Jentoft ME, Middlebrooks EH, Meyer FB, Chaichana KL, Quinones-Hinojosa A (2022) Influence of supramarginal resection on survival outcomes after gross-total resection of IDH-wild-type glioblastoma. J Neurosurg 136:1–8. https://doi.org/10.3171/2020.10.Jns203366
doi: 10.3171/2020.10.Jns203366
pubmed: 34087795
Kim MM, Sun Y, Aryal MP, Parmar HA, Piert M, Rosen B, Mayo CS, Balter JM, Schipper M, Gabel N, Briceño EM, You D, Heth J, Al-Holou W, Umemura Y, Leung D, Junck L, Wahl DR, Lawrence TS, Cao Y (2021) A phase 2 study of dose-intensified Chemoradiation using biologically based Target volume definition in patients with newly diagnosed Glioblastoma. Int J Radiat Oncol Biol Phys 110:792–803. https://doi.org/10.1016/j.ijrobp.2021.01.033
doi: 10.1016/j.ijrobp.2021.01.033
pubmed: 33524546
pmcid: 8920120
Elson A, Paulson E, Bovi J, Siker M, Schultz C, Laviolette PS (2015) Evaluation of pre-radiotherapy apparent diffusion coefficient (ADC): patterns of recurrence and survival outcomes analysis in patients treated for glioblastoma multiforme. J Neurooncol 123:179–188. https://doi.org/10.1007/s11060-015-1782-5
doi: 10.1007/s11060-015-1782-5
pubmed: 25894597