TY  - JOUR
AU  - Shankar, Jai Jai Shiva
AU  - Bata, Adil
AU  - Sinha, Namita
PY  - 2018
DA  - 2018/10/25
TI  - Isolated Diffusion Restriction Preceding Contrast Enhancement in Glioblastoma Multiforme is Associated with Short-Term Survival
JO  - OBM Neurobiology
SP  - 013
VL  - 02
IS  - 04
AB  - (1) Background: Current imaging standard for detecting and assessing glioblastoma multiforme (GBM) progression depends on contrast-enhancement on brain magnetic resonance imaging (MRI). Isolated foci of diffusion restriction have been observed to precede enhancement in GBM. The aim of our study was to investigate the frequency of isolated diffusion restriction that precede corresponding enhancement and to investigate the association between isolated diffusion restriction and survival in patients with GBM. (2) Methods: MRI of the brain, including diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) maps were retrospectively examined in 102 consecutively treated patients with histopathologically confirmed GBM. Images were assessed for the presence of isolated diffusion restriction in GBM and identified lesions were monitored for enhancement on follow-up MRI. Data were collected on the length of time for enhancement to appear, normalized ADC, and overall survival of patients. (3) Results: Forty patients (39.2%) showed areas of isolated diffusion restriction. Ten patients (25%) developed corresponding enhancement on follow-up imaging after an average of 145 days after the index imaging. In patients with isolated restricted diffusion, the mean ADC was 721.4 ± 117.2 mm2/s compared to 888.7 ± 85.2 mm2/s in the normal appearing-white matter (NAWM) in contralateral hemisphere (p<0.001). On survival analysis, the overall survival was longer (p=0.036) in patients with isolated restricted diffusion and these patients had survival benefit (p=0.006) in the early follow-up period. (4) Conclusions: Isolated restricted diffusion in GBM precedes corresponding enhancement in a subset of patients with GBM and was associated with early survival benefit.
SN  - 2573-4407
UR  - https://doi.org/10.21926/obm.neurobiol.1804013
DO  - 10.21926/obm.neurobiol.1804013
ID  - Shankar2018
ER  -