Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: A multi-center study Journal Article
| Authors: | Pope, W. B.; Qiao, X. J.; Kim, H. J.; Lai, A.; Nghiemphu, P.; Xue, X.; Ellingson, B. M.; Schiff, D.; Aregawi, D.; Cha, S.; Puduvalli, V. K.; Wu, J.; Yung, W. K. A.; Young, G. S.; Vredenburgh, J.; Barboriak, D.; Abrey, L. E.; Mikkelsen, T.; Jain, R.; Paleologos, N. A.; Rn, P. L.; Prados, M.; Goldin, J.; Wen, P. Y.; Cloughesy, T. |
| Article Title: | Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: A multi-center study |
| Abstract: | 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'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 9 10-6mm2/s ± 224 (SD), and mean LCP was 0.71 ± 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\1,209 and LCP[0.71 versus ADC-L[1,209 and LCP \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 multicenter (BRAIN) study. © 2012 Springer Science+Business Media, LLC. |
| Keywords: | adult; aged; middle aged; survival rate; young adult; major clinical study; overall survival; bevacizumab; nuclear magnetic resonance imaging; outcome assessment; brain neoplasms; progression free survival; neoplasm recurrence, local; algorithms; irinotecan; confidence interval; proportional hazards model; multicenter study; tumor recurrence; glioblastoma; glioblastoma multiforme; hazard ratio; kaplan meier method; tumor growth; angiogenesis inhibitors; diffusion magnetic resonance imaging; diffusion coefficient; predictive value; histogram; log rank test; progression-free survival; post hoc analysis; classifier; apparent diffusion coefficient; antibodies, monoclonal, humanized |
| Journal Title: | Journal of Neuro-Oncology |
| Volume: | 108 |
| Issue: | 3 |
| ISSN: | 0167-594X |
| Publisher: | Springer |
| Date Published: | 2012-07-01 |
| Start Page: | 491 |
| End Page: | 498 |
| Language: | English |
| DOI: | 10.1007/s11060-012-0847-y |
| PROVIDER: | scopus |
| PUBMED: | 22426926 |
| PMCID: | PMC3997502 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 August 2012" - "CODEN: JNODD" - "Source: Scopus" |
