Prognostic value of preoperative diffusion restriction in glioblastoma

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Published Feb 18, 2024
https://doi.org/10.62438/tunismed.v102i2.4746
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Vol. 102 No. 2 (2024): Tunis med feb 2024

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Emna Labbène
Department of Radiology, Mohamed Kassab Institute of Orthopaedics, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia
Maha Mahmoud
Department of Neuroradiology, National Institute of Neurology Mongi-Ben Hamida, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia
Linda Marrakchi-Kacem
Higher Institute of Biotechnology of Sidi Thabet, Manouba University, National Engineering School of Tunis (ENIT), L3S Laboratory, Tunis-El Manar University, Tunis, Tunisia
Mohamed Ben Hamouda
Department of Neuroradiology, National Institute of Neurology Mongi-Ben Hamida, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

Abstract

Introduction: Although glioblastoma (GBM) has a very poor prognosis, overall survival (OS) in treated patients shows great difference varying from few days to several months. Identifying factors explaining this difference would improve management of patient treatment.  


Aim: To determine the relevance of diffusion restriction in newly diagnosed treatment-naïve GBM patients.


Methods: Preoperative magnetic resonance scans of 33 patients with GBM were reviewed. Regions of interest including all the T2 hyperintense lesion were drawn on diffusion weighted B0 images and transferred to the apparent diffusion coefficient (ADC) map. For each patient, a histogram displaying the ADC values within in the regions of interest was generated. Volumetric parameters including tumor regions with restricted diffusion, parameters derived from histogram and mean ADC value of the tumor were calculated. Their relationship with OS was analyzed.


Results: Patients with mean ADC value < 1415x10-6 mm2/s had a significantly shorter OS (p=0.021).


Among volumetric parameters, the percentage of volume within T2 lesion with a normalized ADC value <1.5 times that in white matter was significantly associated with OS (p=0.0045). Patients with a percentage >23.92% had a shorter OS.


Among parameters derived from histogram, the 50th percentile showed a trend towards significance for OS (p=0.055) with patients living longer when having higher values of 50th percentile. A difference in OS was observed between patients according to ADC peak of histogram but this difference did not reach statistical significance (p=0.0959).


Conclusion: Diffusion magnetic resonance imaging may provide useful information for predicting GBM prognosis.

Keywords:

Glioblastoma, Magnetic resonance imaging, Imaging diffusion MRI, Prognosis

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Author Biographies

Emna Labbène, Department of Radiology, Mohamed Kassab Institute of Orthopaedics, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

Other affiliation:

Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

Maha Mahmoud, Department of Neuroradiology, National Institute of Neurology Mongi-Ben Hamida, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

Other affiliation: 

Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia   

 

Linda Marrakchi-Kacem, Higher Institute of Biotechnology of Sidi Thabet, Manouba University, National Engineering School of Tunis (ENIT), L3S Laboratory, Tunis-El Manar University, Tunis, Tunisia

Other affiliation:

National Engineering School of Tunis (ENIT), L3S Laboratory, Tunis-El Manar University, Tunis, Tunisia

Mohamed Ben Hamouda, Department of Neuroradiology, National Institute of Neurology Mongi-Ben Hamida, Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

Other affiliation:

Faculty of Medicine of Tunis, Tunis-El Manar University, Tunis, Tunisia

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