Mono-exponential, diffusion kurtosis and stretched exponential diffusion MR imaging response to chemoradiation in newly diagnosed glioblastoma.
Mono-exponential, diffusion kurtosis and stretched exponential diffusion MR imaging response to chemoradiation in newly diagnosed glioblastoma.
复制标题
新诊断的胶质母细胞瘤对放化疗的单指数、扩散峰度和拉伸指数扩散 MR 成像反应。
DOI：
10.1007/s11060-018-2910-9
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发表时间：
2018-09
影响因子：
3.9
通讯作者：
Ellingson BM
中科院分区：
文献类型：
--
作者：
Chakhoyan A;Woodworth DC;Harris RJ;Lai A;Nghiemphu PL;Liau LM;Pope WB;Cloughesy TF;Ellingson BM
为了量化在新诊断的胶质母细胞瘤(GBM)化疗前后使用单指数、扩散峰度成像(DKI)和扩展指数(SE)模型所获得的扩散MRI测量结果的变化和预后价值。23例患者在手术后、化疗前和治疗结束后7天内进行了弥散加权成像(DWI)，b值从0到500s/mm2不等。计算化疗前后的单指数扩散(表观扩散系数：ADc)、各向同性(非方向性)的表观扩散系数(DAPP)和峰度(KAPP)模型，以及包括分布扩散系数(DDC)和平均体素内异质性(α)的SE模型。计算正常白质(NAWM)和对比剂增强肿瘤(CET)的中位数。用放化疗前后弥散变化的大小预测总生存期(OS)。在放化疗期间，NAWM中的扩散系数在所有扩散测量中都是一致的，而CET中的扩散系数测量(ADC、DAPP和DDC)发生了显著变化。放化疗前的ADC、DAPP和DDC测量之间有很强的正相关性；然而，放化疗后这种相关性很弱，这表明细胞毒治疗后的微结构环境更加复杂。当结合基线肿瘤体积和MGMT状态时，年龄和ADC值的变化增加了显著的预后价值，而更复杂的扩散模型在预测OS方面没有显著价值。尽管化疗后组织复杂性增加，但先进的扩散模型具有更长的采集时间，提供了基本可比的扩散系数测量，而且与单指数ADC图相比，似乎没有提供额外的预后价值。
To quantify changes and prognostic value of diffusion MRI measurements obtained using mono-exponential, diffusion kurtosis imaging (DKI) and stretched exponential (SE) models prior and after chemoradiation in newly diagnosed glioblastoma (GBM). Diffusion-weighted images (DWIs) were acquired in twenty-three patients following surgery, prior chemoradiation and within 7 days following completion of treatment, using b-values ranging from 0 to 5000s/mm2. Mono-exponential diffusion (apparent diffusion coefficient: ADC), isotropic (non-directional) DKI model with apparent diffusivity (Dapp) and kurtosis (Kapp) estimates as well as SE model with distributed-diffusion coefficient (DDC) and mean intra-voxel heterogeneity (α) were computed for all patients prior and after chemoradiation. Median values were calculated for normal appearing white matter (NAWM) and contrast-enhancing tumor (CET). The magnitudes of diffusion change prior and after chemoradiation were used to predict overall survival (OS). Diffusivity in NAWM was consistent for all diffusion measures during chemoradiation, while diffusivity measurements (ADC, Dapp and DDC) within CET changed significantly. A strong positive correlation existed between ADC, Dapp, and DDC measurements prior to chemoradiation; however, this association was weak following chemoradiation, suggesting a more complex microstructural environment after cytotoxic therapy. When combined with baseline tumor volume and MGMT status, age and ADC changes added significant prognostic values, whereas more complex diffusion models did not show significant value in predicting OS. Despite increased tissue complexity following chemoradiation, advanced diffusion models have longer acquisition times, provide largely comparable measures of diffusivity, and do not appear to provide additional prognostic value compared to mono-exponential ADC maps.
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