Dataset Information

Restriction spectrum imaging predicts response to bevacizumab in patients with high-grade glioma.

ABSTRACT:

Background

Diffusion-weighted imaging has shown initial promise for evaluating response to bevacizumab in patients with high-grade glioma (HGG). However, it is well recognized that the apparent diffusion coefficient (ADC) is influenced by bevacizumab-induced reductions in edema, which may limit its prognostic value. We demonstrate that an advanced diffusion-weighted imaging technique, restriction spectrum imaging (RSI), improves the evaluation of response to bevacizumab because unlike ADC, RSI is not affected by resolution of edema.

Methods

RSI and ADC maps were analyzed for 40 patients with HGG prior to and following initiation of bevacizumab. Volumes of interest were drawn for regions of contrast enhancement (CE) and fluid attenuated inversion recovery (FLAIR) hyperintensity and histogram percentiles within volumes of interest were calculated for ADC 10th percentile (ADC-CE_10%, ADC-FLAIR_10%) and for RSI 90th percentile (RSI-CE_90%, RSI-FLAIR_90%). Cox proportional hazard models were used to evaluate the relationship between imaging parameters, progression-free survival (PFS), and overall survival (OS).

Results

An increase in RSI-FLAIR_90% following bevacizumab was the strongest predictor of poor PFS (P= .016) and OS (P= .004), whereas decreases in ADC-FLAIR_10% showed a weaker association with OS only (P= .041). Within the CE region, increases in RSI-CE_90% alone were associated with poorer OS. Correlational analysis revealed that decreases in FLAIR volume were associated with decreases in ADC-FLAIR_10%, but not with changes in RSI-FLAIR_90%.

Conclusion

RSI is less influenced by changes in edema, conferring an advantage of RSI over ADC for evaluating response to anti-angiogenic therapy in patients with HGG.

SUBMITTER: McDonald CR

PROVIDER: S-EPMC5063514 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Publications

Restriction spectrum imaging predicts response to bevacizumab in patients with high-grade glioma.

McDonald Carrie R CR Delfanti Rachel L RL Krishnan Anitha P AP Leyden Kelly M KM Hattangadi-Gluth Jona A JA Seibert Tyler M TM Karunamuni Roshan R Elbe Pia P Kuperman Joshua M JM Bartsch Hauke H Piccioni David E DE White Nathan S NS Dale Anders M AM Farid Nikdokht N

Neuro-oncology 20160421 11

<h4>Background</h4>Diffusion-weighted imaging has shown initial promise for evaluating response to bevacizumab in patients with high-grade glioma (HGG). However, it is well recognized that the apparent diffusion coefficient (ADC) is influenced by bevacizumab-induced reductions in edema, which may limit its prognostic value. We demonstrate that an advanced diffusion-weighted imaging technique, restriction spectrum imaging (RSI), improves the evaluation of response to bevacizumab because unlike AD ...[more]

PMID: 27106406

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Project description:PurposeWe evaluate a novel magnetic resonance imaging (MRI) technique to improve detection of aggressive prostate cancer (PCa).Materials and methodsWe performed a retrospective analysis of pre-surgical prostate MRI scans using an advanced diffusion-weighted imaging technique called restriction spectrum imaging (RSI), which can be presented as a normalized z-score statistic. Scans were acquired prior to radical prostatectomy. Prostatectomy specimens were processed using whole-mount sectioning and regions of interest (ROIs) were drawn around individual PCa tumors. Corresponding ROIs were drawn on the MRI imaging and paired with ROIs in regions with no pathology. RSI z-score and conventional apparent diffusion coefficient (ADC) values were recorded for each ROI. Paired t-test, ANOVA, and logistic regression analyses were performed.ResultsWe evaluated 28 patients with 64 ROIs (28 benign and 36 PCa). The mean difference in RSI z-score (PCa ROI-Benign ROI) was 2.17 (SE = 0.11; p < 0.001) and in ADC was 551 mm(2)/s (SE = 80 mm(2)/s; paired t-test, p < 0.001). The differences in the means among all groups (benign, primary Gleason 3, and primary Gleason 4) was significant for both RSI z-score (F 3,64 = 97.7, p < 0.001) and ADC (F 3,64 = 13.9, p < 0.001). A t-test was performed on only PCa tumor ROIs (n = 36) to determine PCa aggressiveness (Gleason 3 vs. Gleason 4) revealing that RSI z-score was still significant (p = 0.03), whereas, ADC values were no longer significant (p = 0.08). In multivariable analysis adjusting for age and race, RSI z-score was associated with PCa aggressiveness (OR 10.3, 95% CI: 1.4-78.0, p = 0.02) while ADC trended to significance (p = 0.07).ConclusionThe RSI-derived normalized cellularity index is associated with aggressive PCa as determined by pathologic Gleason scores. Further utilization of RSI techniques may serve to enhance standardized reporting systems for PCa in the future.

Dataset Information

Restriction spectrum imaging predicts response to bevacizumab in patients with high-grade glioma.

Background

Methods

Results

Conclusion

Publications

Restriction spectrum imaging predicts response to bevacizumab in patients with high-grade glioma.

Similar Datasets

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