Intravoxel incoherent motion metrics as potential biomarkers for survival in glioblastoma

Josep Puig, Javier Sánchez-González, Gerard Blasco, Pepus Daunis-I-Estadella, Christian Federau, Ángel Alberich-Bayarri, Carles Biarnes, Kambiz Nael, Marco Essig, Rajan Jain, Max Wintermark, Salvador Pedraza

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5 Scopus citations

Abstract

Objective: 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. Methods: 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. Results: We found that fCER and D∗CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D∗CER>21.712×10-3mm2/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. Conclusions: The IVIM-metrics fCER and D∗CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.

Original languageEnglish (US)
Article numbere0158887
JournalPLoS One
Volume11
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

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ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Puig, J., Sánchez-González, J., Blasco, G., Daunis-I-Estadella, P., Federau, C., Alberich-Bayarri, Á., Biarnes, C., Nael, K., Essig, M., Jain, R., Wintermark, M., & Pedraza, S. (2016). Intravoxel incoherent motion metrics as potential biomarkers for survival in glioblastoma. PLoS One, 11(7), [e0158887]. https://doi.org/10.1371/journal.pone.0158887