This study aimed to evaluate potential posttreatment changes in ADC values within the tissue surrounding the enhancing lesion, particularly in areas not exhibiting MRI characteristics of involvement. Additionally, the objective was to investigate the correlations among ADC values, treatment response, and survival outcomes in individuals diagnosed with gliomas. This retrospective study included a total of 49 patients that underwent either stereotactic biopsy or maximal surgical resection. Histologically confirmed as Grade III or IV gliomas, all cases adhered to the 2016 and 2021 WHO classifications, with subsequent radio-chemotherapy administered post-surgery. Patients were divided into two groups: short and long survival groups. Baseline and follow-up MRI scans were obtained on a 1.5 T MRI scanner. Two ROI circles were positioned near the enhancing area, one ROI in the NAWM ipsilateral to the neoplasm and another symmetrically in the contralateral hemisphere on ADC maps. At follow-up there was a significant difference in both ipsilateral and contralateral NAWM between the two groups, −0.0857 (p= 0.004) and −0.0607 (p= 0.037), respectively. There was a weak negative correlation between survival and ADC values in ipsilateral and contralateral NAWM at the baseline with the correlation coefficient −0.328 (p= 0.02) and −0.302 (p= 0.04), respectively. The correlation was stronger at the follow-up. The findings indicate that ADC values in normal-appearing white matter (NAWM) may function as a prognostic biomarker in patients with diffuse gliomas.
本研究旨在评估增强病灶周围组织，特别是在未显示MRI受累特征的区域中，表观扩散系数（ADC）值在治疗后的潜在变化。此外，研究还探讨了ADC值与胶质瘤患者的治疗反应及生存结局之间的相关性。这项回顾性研究共纳入49例接受立体定向活检或最大范围手术切除的患者。所有病例经组织学证实为III级或IV级胶质瘤，均遵循2016年和2021年WHO分类标准，并在术后接受了放化疗。根据生存期将患者分为短期生存组和长期生存组。使用1.5 T MRI扫描仪获取基线和随访MRI图像。在ADC图上，于增强区域附近设置两个感兴趣区（ROI）圆形区域：一个位于肿瘤同侧的正常表现白质（NAWM），另一个对称地位于对侧半球。随访结果显示，两组患者在同侧和对侧NAWM的ADC值均存在显著差异，分别为-0.0857（p=0.004）和-0.0607（p=0.037）。基线时，生存期与同侧及对侧NAWM的ADC值呈弱负相关，相关系数分别为-0.328（p=0.02）和-0.302（p=0.04），随访期间相关性增强。研究结果表明，正常表现白质（NAWM）的ADC值可能作为弥漫性胶质瘤患者的预后生物标志物。
Prognostic Value of Apparent Diffusion Coefficient (ADC) in Patients with Diffuse Gliomas
肿瘤(癌症)患者之家