Apparent diffusion coefficient of glial neoplasms: Correlation with fluorodeoxyglucose - Positron-emission tomography and gadolinium-enhanced MR imaging Journal Article


Authors: Holodny, A. I.; Makeyev, S.; Beattie, B.; Riad, S.; Blasberg, R. G.
Article Title: Apparent diffusion coefficient of glial neoplasms: Correlation with fluorodeoxyglucose - Positron-emission tomography and gadolinium-enhanced MR imaging
Abstract: BACKGROUND AND PURPOSE: Gd-enhancement provides essential information in the assessment of brain tumors. However, enhancement does not always correlate with histology or disease activity, especially in the setting of current therapies. Our aim was to compare FDG-PET scans to ADC maps and Gd-enhanced MR images in patients with glial neoplasms to assess whether DWI might offer information not available on routine MR imaging sequences and whether such findings have prognostic significance. MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective review, which was conducted in full compliance with HIPAA regulations. Twenty-one patients (11 men and 10 women) with glial tumors underwent FDG-PET and MR imaging, including ADC and Gd-enhancement. Subjectively, regions of interest were drawn around the following areas: 1) increased FDG uptake, 2) decreased signal intensity on ADC maps, and 3) Gd-enhancement. Objectively, FDG-PET and MR images were co-registered, and pixel-by-pixel comparison of ADC to PET values was made for all regions of interest. Correlation coefficients (r values) were calculated for each region of interest. Percentage overlap between regions of interest was calculated for each case. RESULTS: Subjective evaluation showed 60% of patients with excellent or good correlation between ADC maps and FDG-PET. Pixel-by-pixel comparison demonstrated r values that ranged from -0.72 to -0.21. There was significantly greater overlap between decreased ADC and increased FDG-PET uptake (67.1 ± 15.5%) versus overlap between Gd-enhancement and increased FDG-PET uptake (54.4 ± 27.5%) (P < .05). ADC overlap was greater with increased FDG-PET than with Gd-enhancement in 8/9 cases. Survival data revealed that the presence of restricted diffusion on ADC correlated with patient survival (P < .0001). CONCLUSIONS: ADC maps in patients with brain tumors provide unique information that is analogous to FDG-PET. There is a greater overlap between ADC and FDG-PET compared with Gd-enhancement. ADC maps can serve to approximate tumor grade and predict survival.
Keywords: adult; clinical article; controlled study; aged; middle aged; survival analysis; retrospective studies; gadolinium; nuclear magnetic resonance imaging; outcome assessment; positron emission tomography; brain tumor; glioma; brain neoplasms; magnetic resonance imaging; diagnostic imaging; medical record review; retrospective study; prediction; survival time; severity of illness index; image enhancement; contrast enhancement; image quality; glioblastoma; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; predictive value of tests; intermethod comparison; oligodendroglioma; astrocytoma; diffusion weighted imaging
Journal Title: American Journal of Neuroradiology
Volume: 31
Issue: 6
ISSN: 0195-6108
Publisher: American Society of Neuroradiology  
Date Published: 2010-06-01
Start Page: 1042
End Page: 1048
Language: English
DOI: 10.3174/ajnr.A1989
PUBMED: 20150307
PROVIDER: scopus
PMCID: PMC7963953
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: AAJND" - "Source: Scopus"
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  1. Ronald G Blasberg
    272 Blasberg
  2. Andrei Holodny
    206 Holodny
  3. Bradley Beattie
    131 Beattie
  4. Shareef Riad
    2 Riad