Intravoxel Incoherent Motion Metrics as Potential Biomarkers for Survival in Glioblastoma

• Published in: PloS one Vol. 11; no. 7; p. e0158887
• Main Authors: Puig, Josep, Sánchez-González, Javier, Blasco, Gerard, Daunis-I-Estadella, Pepus, Federau, Christian, Alberich-Bayarri, Ángel, Biarnes, Carles, Nael, Kambiz, Essig, Marco, Jain, Rajan, Wintermark, Max, Pedraza, Salvador
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.07.2016; Public Library of Science (PLoS)
• Subjects: Aged; Analysis; Biological markers; Biology and Life Sciences; Biomarkers; Biomarkers - metabolism; Biomedical research; Blood; Brain; Brain - diagnostic imaging; Brain - pathology; Brain cancer; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - mortality; Brain research; Brain tumors; Cervell; Diagnosis; Diffusion coefficient; Diffusion Magnetic Resonance Imaging; Female; Gene mapping; Glioblastoma; Glioblastoma - diagnostic imaging; Glioblastoma - mortality; Glioblastomas; Glioma; Gliomas; Gliomes; Hazards; Histology; Humans; Image contrast; Image Processing, Computer-Assisted; Kaplan-Meier Estimate; Magnetic resonance; Magnetic resonance imaging; Male; Medical diagnosis; Medicine and Health Sciences; Middle Aged; Motion; NMR; Nuclear magnetic resonance; Observer Variation; Patients; Perfusion; Physical Sciences; Prognosis; Proportional Hazards Models; Prospective Studies; Radiation therapy; Radiology; Research and Analysis Methods; Ressonància magnètica; Sensitivity and Specificity; Survival; Treatment Outcome; Tumors; United States; New York; Palo Alto California; United States > US; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0158887

Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma. Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses. We found that fCER and D*CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D*CER>21.712 x10-3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162-25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy. The IVIM-metrics fCER and D*CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.