The Potential Role of Peritumoral Apparent Diffusion Coefficient Evaluation in Differentiating Glioblastoma and Solitary Metastatic Lesions of the Brain

2021 ◽  
Vol 17 ◽  
Author(s):  
Murat Tepe ◽  
Suzan Saylisoy ◽  
Ugur Toprak ◽  
Ibrahim Inan
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Apparent Diffusion Coefficient ◽  
Sensitivity And Specificity ◽  
Brain Mri ◽  
Solitary Metastasis ◽  
Metastatic Lesions ◽  
Institutional Review ◽  
Apparent Diffusion ◽  
Adc Values

Objective: Differentiating glioblastoma (GBM) and solitary metastasis is not always possible using conventional magnetic resonance imaging (MRI) techniques. In conventional brain MRI, GBM and brain metastases are lesions with mostly similar imaging findings. In this study, we investigated whether apparent diffusion coefficient (ADC) ratios, ADC gradients, and minimum ADC values in the peritumoral edema tissue can be used to discriminate between these two tumors. Methods: This retrospective study was approved by the local institutional review board with a waiver of written informed consent. Prior to surgical and medical treatment, conventional brain MRI and diffusion-weighted MRI (b = 0 and b = 1000) images were taken from 43 patients (12 GBM and 31 solitary metastasis cases). Quantitative ADC measurements were performed on the peritumoral tissue from the nearest segment to the tumor (ADC1), the middle segment (ADC2), and the most distant segment (ADC3). The ratios of these three values were determined proportionally to calculate the peritumoral ADC ratios. In addition, these three values were subtracted from each other to obtain the peritumoral ADC gradients. Lastly, the minimum peritumoral and tumoral ADC values, and the quantitative ADC values from the normal appearing ipsilateral white matter, contralateral white matter and ADC values from cerebrospinal fluid (CSF) were recorded. Results: For the differentiation of GBM and solitary metastasis, ADC3 / ADC1 was the most powerful parameter with a sensitivity of 91.7% and specificity of 87.1% at the cut-off value of 1.105 (p < 0.001), followed by ADC3 / ADC2 with a cut-off value of 1.025 (p = 0.001), sensitivity of 91.7%, and specificity of 74.2%. The cut-off, sensitivity and specificity of ADC2 / ADC1 were 1.055 (p = 0.002), 83.3%, and 67.7%, respectively. For ADC3 – ADC1, the cut-off value, sensitivity and specificity were calculated as 150 (p < 0.001), 91.7% and 83.9%, respectively. ADC3 – ADC2 had a cut-off value of 55 (p = 0.001), sensitivity of 91.7%, and specificity of 77.4 whereas ADC2 – ADC1 had a cut-off value of 75 (p = 0.003), sensitivity of 91.7%, and specificity of 61.3%. Among the remaining parameters, only the ADC3 value successfully differentiated between GBM and metastasis (GBM 1802.50 ± 189.74 vs. metastasis 1634.52 ± 212.65, p = 0.022). Conclusion: The integration of the evaluation of peritumoral ADC ratio and ADC gradient into conventional MR imaging may provide valuable information for differentiating GBM from solitary metastatic lesions.

scholarly journals Variability of apparent diffusion coefficient in the brain in women during follicular and luteal phases of the menstrual cycle

2018 ◽  
Vol 32 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Kadihan Yalçin Şafak
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Menstrual Cycle ◽  
Apparent Diffusion Coefficient ◽  
Lateral Ventricle ◽  
Luteal Phase ◽  
Follicular Phase ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Brain

Purpose To investigate the variability of apparent diffusion coefficient (ADC) in the brain in women during follicular and luteal phases of the menstrual cycle. Methods The present study included 32 females of reproductive age with regular menstruation. The participants were divided into two groups as group 1: females in the follicular phase, and group 2: females in the luteal phase. The regions of interest were manually drawn on the structures of the T2-weighted images (frontal gray and white matter, parietal gray and white matter, temporal gray and white matter, occipital gray and white matter, cerebellar gray and white matter, caudate nucleus, putamen, thalamus, internal capsule, pons, cerebrospinal fluid (CSF) in the frontal and in the occipital horn of the lateral ventricle and CSF in the middle part of the lateral ventricle). ADC values were averaged for each patient. We used Kruskal–Wallis ANOVA for more than two groups but used Mann Whitney U test for comparison of ADC values between the group of 18 females in the follicular phase and the group of 14 females in the luteal phase. Results No statistically significant differences were observed among the groups in terms of the ADC value of each neuroanatomic structure that was evaluated. Conclusion We did not determine a significant difference among volunteers at the two different phases of the menstrual cycle in terms of ADC values measured from different regions of the brain. However, although not statistically significant, ADC values measured from almost all parts of the brain were higher at the luteal phase than at the follicular phase.

Assessment of Apparent Diffusion Coefficient of Normal Fetal Brain Development from Gestational Age Week 24 Up to Term Age: A Preliminary Study

2014 ◽  
Vol 37 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Rui Han ◽  
Lu Huang ◽  
Ziyan Sun ◽  
Dongyou Zhang ◽  
Xinlin Chen ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Apparent Diffusion Coefficient ◽  
Brain Development ◽  
Gestational Age ◽  
Fetal Brain ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Fetal Brain Development ◽  
Adc Values

Objectives: This study was designed to investigate the feasibility of apparent diffusion coefficient (ADC) values in evaluating normal fetal brain development from gestational week 24 up to term age. Methods: Diffusion-weighted imaging (DWI) was performed on 40 normal fetuses (with normal results on sonography and normal fetal MRI results), with two b-values of 0 and 600 s/mm2 in the three (x, y, z) orthogonal axes. Ten regions of interest (ROIs) were manually placed symmetrically in the bilateral frontal white matter (FWM), occipital white matter (OWM), thalamus (THAL), basal ganglia (BG), and cerebellar hemispheres (CH). ADC values of the ten ROIs in all subjects were measured by two radiologists independently. One-way ANOVA was used to calculate the differences among the five regions in the fetal brain and linear regression analysis was used to evaluate the correlation between ADC values and gestational age (GA). p < 0.05 was considered significantly different. Results: Mean GA was 31.3 ± 3.9 (range 24-41) weeks. The overall mean ADC values (×10-6 mm2/s) of the fetuses were 1,800 ± 214 (FWM), 1,400 ± 100 (BG), 1,300 ± 126 (THAL), 1,700 ± 133 (OWM) and 1,400 ± 155 (CH), respectively. The ADC value of BG was not significantly different from those of THAL and CH, while the other four ROIs had significant differences with each other. The ADC values of BG, THAL, OWM and CH had strong negative correlations with increasing GA (R were -0.568, -0.716, -0.830 and -0.700, respectively, all p < 0.01), OWM declined fastest with GA, followed by CH and THAL, the slowest being BG. The ADC value of FWM had no significant change with GA (p = 0.366). Conclusions: The measurement of ADC values is feasible to evaluate fetal brain development with high reliability and reproducibility.

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

Diagnostic value of apparent diffusion coefficient in differentiating between high-grade gliomas and brain metastases

2017 ◽  
Vol 59 (5) ◽  
pp. 599-605 ◽  
Author(s):  
Ionut Caravan ◽  
Cristiana Augusta Ciortea ◽  
Alexandra Contis ◽  
Andrei Lebovici
Keyword(s):  
Diffusion Coefficient ◽  
Brain Metastases ◽  
Apparent Diffusion Coefficient ◽  
Curve Analysis ◽  
High Grade ◽  
Peritumoral Edema ◽  
Roc Curve Analysis ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Mean

Background High-grade gliomas (HGGs) and brain metastases (BMs) can display similar imaging characteristics on conventional MRI. In HGGs, the peritumoral edema may be infiltrated by the malignant cells, which was not observed in BMs. Purpose To determine whether the apparent diffusion coefficient values could differentiate HGGs from BMs. Material and Methods Fifty-seven patients underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before treatment. The minimum and mean ADC in the enhancing tumor (ADCmin, ADCmean) and the minimum ADC in the peritumoral region (ADCedema) were measured from ADC maps. To determine whether there was a statistical difference between groups, ADC values were compared. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGGs and BMs. Results The mean ADCmin values in the intratumoral regions of HGGs were significantly higher than those in BMs. No differences were observed between groups regarding ADCmean values. The mean ADCmin values in the peritumoral edema of HGGs were significantly lower than those in BMs. According to ROC curve analysis, a cutoff value of 1.332 × 10−3 mm2/s for the ADCedema generated the best combination of sensitivity (95%) and specificity (84%) for distinguishing between HGGs and BMs. The same value showed a sensitivity of 95.6% and a specificity of 100% for distinguishing between GBMs and BMs. Conclusion ADC values from DWI were found to distinguish between HGGs and solitary BMs. The peritumoral ADC values are better than the intratumoral ADC values in predicting the tumor type.

scholarly journals Apparent diffusion coefficient restriction in the white matter: going beyond acute brain territorial ischemia

2011 ◽  
Vol 3 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Valentina Citton ◽  
Alberto Burlina ◽  
Claudio Baracchini ◽  
Massimo Gallucci ◽  
Alessia Catalucci ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Apparent Diffusion Coefficient ◽  
Apparent Diffusion

Added Value of Quantitative Apparent Diffusion Coefficient Values for Neuroprognostication After Cardiac Arrest

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011991
Author(s):  
Anke Wouters ◽  
Lauranne Scheldeman ◽  
Sam Plessers ◽  
Ronald Peeters ◽  
Sarah Cappelle ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Brain Mri ◽  
Multivariate Model ◽  
Added Value ◽  
Neurological Recovery ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion

ObjectiveTo test the prognostic value of brain MRI in addition to clinical and electrophysiological variables in post-cardiac arrest (CA) patients, we explored data from the randomized Neuroprotect post-CA trial (NCT02541591).MethodsIn this trial brain MRI’s were prospectively obtained. We calculated receiver operating characteristic curves for the average Apparent Diffusion Coefficient (ADC) value and percentage of brain voxels with an ADC value < 650 x 10-6 mm2/s and < 450 x 10-6 mm2/s. We constructed multivariable logistic regression models with clinical characteristics, electroencephalogram (EEG), somatosensory evoked potentials (SSEP) and ADC value as independent variables, to predict good neurological recovery.ResultsIn 79/102 patients MRI data were available and in 58/79 patients all other data were available. At 180 days post-CA, 25/58 (43%) patients had good neurological recovery. In univariable analysis of all tested MRI parameters, average ADC value in the postcentral cortex had the highest accuracy to predict good neurological recovery with an AUC of 0.78. In the most optimal multivariate model which also included corneal reflexes and EEG, this parameter remained an independent predictor of good neurological recovery (AUC = 0.96, false positive = 27%). This model provided a more accurate prediction compared to the most optimal combination of EEG, corneal reflexes and SSEP (p=0.03).ConclusionAdding information on brain MRI in a multivariate model may improve the prediction of good neurological recovery in post-CA patients.Classification of Evidence:"This study provides Class III evidence that MRI ADC features predict neurological recovery in post-cardiac arrest patients."

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