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Lower apparent diffusion coefficients indicate distinct prognosis in low-grade and high-grade glioma

  • Clinical Study
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Abstract

Tumor grade and molecular variants influence the survival of patients with glioma. The apparent diffusion coefficient (ADC) map is a non-invasive tool for evaluating the outcomes and response to therapy in glioma. In this study, we investigated the correlation between the tumor grade and prognostic biomarkers with the ADC in glioma patients. Eighty-two patients with supratentorial glioma were identified via analysis of surgical specimens and neuroradiological data. Using the World Health Organization grade, histological subtype, and molecular variants (1p/19q codeletion, isocitrate dehydrogenase 1/2 mutation, Ki-67 index, O6-methylguanine DNA methyltransferase, P53, and vascular endothelial growth factor immunoactivity) as prognostic biomarkers, we performed receiver operating characteristic analysis and multiple linear regression to assess the association between the magnetic resonance diffusion parameter and mean ADC and the prognostic factors of glioma pathology. Univariate analysis and multiple linear regression revealed inverse correlations between the ADC values and the tumor grade, oligodendrocytoma histology, and 1p/19q codeletion. A threshold mean ADC value could predict the 1p/19q chromosomal status in WHO II gliomas with 72 % sensitivity and 88 % specificity (area under the curve 0.82, 95 % confidence interval 0.68–0.97) and could distinguish low-grade glioma with low-risk factors from the high-risk group (P < 0.01). The mean ADC value could be used as a non-invasive tool to evaluate the prognosis of supratentorial glioma patients. A threshold mean ADC value could be used to predict the 1p/19q codeletion and to identify low-risk low-grade gliomas (LGGs). Lower ADC values are indicative of a favorable prognosis in LGGs.

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Acknowledgments

The authors would like to thank Dr. Zhang Ming-Yu of the Department of Neuroimaging at Beijing Tiantan Hospital for his assistance with the image analysis and Dr. Ho Lok Yan of the Department of Neurosurgery at Princess Margaret Hospital in Hong Kong and Lian-Xiong Yuan of the Department of Statistics and Epidemiology, School of Public Health, at Sun Yat-Sen University for their assistance with the manuscript preparation and data analysis.

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None.

Disclosure of funding

Beijing Natural Science Foundation (7122061 to Song Lin). No personal or institutional financial interest in drugs, materials, or devices described in our submission

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China

    Yong Cui, Li Ma, Zhe Zhang, Haihui Jiang & Song Lin

  2. Department of Neuroimaging, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China

    Xuzhu Chen

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  1. Yong Cui
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  2. Li Ma
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  3. Xuzhu Chen
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  4. Zhe Zhang
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  6. Song Lin
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Correspondence to Song Lin.

Additional information

Yong Cui and Li Ma have contributed equally to this study.

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Cui, Y., Ma, L., Chen, X. et al. Lower apparent diffusion coefficients indicate distinct prognosis in low-grade and high-grade glioma. J Neurooncol 119, 377–385 (2014). https://doi.org/10.1007/s11060-014-1490-6

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