Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study

作者：Pope Whitney B^*; Qiao Xin Joe; Kim Hyun J; Lai Albert; Nghiemphu Phioanh; Xue Xi; Ellingson Benjamin M; Schiff David; Aregawi Dawit; Cha Soonmee; Puduvalli Vinay K; Wu Jing; Yung Wai Kwan A; Young Geoffrey S; Vredenburgh James; Barboriak Dan; Abrey Lauren E; Mikkelsen Tom; Jain Rajan; Paleologos Nina A; Lada Patricia; Prados Michael; Goldin Jonathan; Wen Patrick Y; Cloughesy Timothy

来源：Journal of Neuro-Oncology, 2012, 108(3): 491-498.

DOI：10.1007/s11060-012-0847-y

• Apparent diffusion coefficient
• Glioblastoma multiforme
• Progression-free survival

We have tested the predictive value of apparent diffusion coefficient (ADC) histogram analysis in stratifying progression-free survival (PFS) and overall survival (OS) in bevacizumab-treated patients with recurrent glioblastoma multiforme (GBM) from the multi-center BRAIN study. Available MRI%26apos;s from patients enrolled in the BRAIN study (n = 97) were examined by generating ADC histograms from areas of enhancing tumor on T1 weighted post-contrast images fitted to a two normal distribution mixture curve. ADC classifiers including the mean ADC from the lower curve (ADC-L) and the mean lower curve proportion (LCP) were tested for their ability to stratify PFS and OS by using Cox proportional hazard ratios and the Kaplan-Meier method with log-rank test. Mean ADC-L was 1,209 x 10(-6)mm(2)/s +/- A 224 (SD), and mean LCP was 0.71 +/- A 0.23 (SD). Low ADC-L was associated with worse outcome. The hazard ratios for 6-month PFS, overall PFS, and OS in patients with less versus greater than mean ADC-L were 3.1 (95 % confidence interval: 1.6, 6.1; P = 0.001), 2.3 (95 % CI: 1.3, 4.0; P = 0.002), and 2.4 (95 % CI: 1.4, 4.2; P = 0.002), respectively. In patients with ADC-L %26lt; 1,209 and LCP %26gt; 0.71 versus ADC-L %26gt; 1,209 and LCP %26lt; 0.71, there was a 2.28-fold reduction in the median time to progression, and a 1.42-fold decrease in the median OS. The predictive value of ADC histogram analysis, in which low ADC-L was associated with poor outcome, was confirmed in bevacizumab-treated patients with recurrent GBM in a post hoc analysis from the multi-center (BRAIN) study.

• 出版日期2012-7