Serial MR diffusion to predict treatment response in high-grade pediatric brain tumors: a comparison of regional and voxel-based diffusion change metrics
| Autor: | Tim Jaspan, Muftah Manita, Daniel Rodriguez Gutierrez, Richard Grundy, Robert A. Dineen, Dorothee P. Auer |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Mass diffusivity Diffusion map Contrast Media computer.software_genre serial diffusion Young Adult Voxel Medicine Humans Diffusion (business) Child pediatric tumor Principal Component Analysis Receiver operating characteristic medicine.diagnostic_test fDM business.industry Brain Neoplasms Infant Magnetic resonance imaging Retrospective cohort study Chemoradiotherapy Prognosis Surgery Diffusion Magnetic Resonance Imaging Oncology ROC Curve ADC Child Preschool Basic and Translational Investigations ADC fDM Pediatric tumor Response prediction Serial diffusion Female response prediction Neurology (clinical) Neoplasm Grading Neoplasm Recurrence Local business Nuclear medicine computer Biomarkers Diffusion MRI Follow-Up Studies |
| Zdroj: | Neuro-Oncology |
| ISSN: | 1523-5866 1522-8517 |
| Popis: | Background Assessment of treatment response by measuring tumor size is known to be a late and potentially confounded response index. Serial diffusion MRI has shown potential for allowing earlier and possibly more reliable response assessment in adult patients, with limited experience in clinical settings and in pediatric brain cancer. We present a retrospective study of clinical MRI data in children with high-grade brain tumors to assess and compare the values of several diffusion change metrics to predict treatment response. Methods Eighteen patients (age range, 1.9–20.6 years) with high-grade brain tumors and serial diffusion MRI (pre- and posttreatment interval range, 1–16 weeks posttreatment) were identified after obtaining parental consent. The following diffusion change metrics were compared with the clinical response status assessed at 6 months: (1) regional change in absolute and normalized apparent diffusivity coefficient (ADC), (2) voxel-based fractional volume of increased (fiADC) and decreased ADC (fdADC), and (3) a new metric based on the slope of the first principal component of functional diffusion maps (fDM). Results Responders (n = 12) differed significantly from nonresponders (n = 6) in all 3 diffusional change metrics demonstrating higher regional ADC increase, larger fiADC, and steeper slopes (P < .05). The slope method allowed the best response prediction (P < .01, η2 = 0.78) with a classification accuracy of 83% for a slope of 58° using receiver operating characteristic (ROC) analysis. Conclusions We demonstrate that diffusion change metrics are suitable response predictors for high-grade pediatric tumors, even in the presence of variable clinical diffusion imaging protocols. |
| Databáze: | OpenAIRE |
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