TY - JOUR
T1 - Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625
T2 - A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma
AU - Ellingson, Benjamin M.
AU - Kim, Eunhee
AU - Woodworth, Davis C.
AU - Marques, Helga
AU - Boxerman, Jerrold L.
AU - Safriel, Yair
AU - McKinstry, Robert C.
AU - Bokstein, Felix
AU - Jain, Rajan
AU - Chi, T. Linda
AU - Sorensen, A. Gregory
AU - Gilbert, Mark R.
AU - Barboriak, Daniel P.
N1 - Publisher Copyright:
© 2015, Spandidos Publications. All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Functional diffusion mapping (fDM) is a cancer imaging technique that quantifies voxelwise changes in apparent diffusion coefficient (ADC). Previous studies have shown value of fDMs in bevacizumab therapy for recurrent glioblastoma multiforme (GBM). The aim of the present study was to implement explicit criteria for diffusion MRI quality control and independently evaluate fDM performance in a multicenter clinical trial (RTOG 0625/ACRIN 6677). A total of 123 patients were enrolled in the current multicenter trial and signed institutional review board-approved informed consent at their respective institutions. MRI was acquired prior to and 8 weeks following therapy. A 5-point QC scoring system was used to evaluate DWI quality. fDM performance was evaluated according to the correlation of these metrics with PFS and OS at the first follow-up time-point. Results showed ADC variability of 7.3% in NAWM and 10.5% in CSF. A total of 68% of patients had usable DWI data and 47% of patients had high quality DWI data when also excluding patients that progressed before the first follow-up. fDM performance was improved by using only the highest quality DWI. High pre-treatment contrast enhancing tumor volume was associated with shorter PFS and OS. A high volume fraction of increasing ADC after therapy was associated with shorter PFS, while a high volume fraction of decreasing ADC was associated with shorter OS. In summary, DWI in multicenter trials are currently of limited value due to image quality. Improvements in consistency of image quality in multicenter trials are necessary for further advancement of DWI biomarkers.
AB - Functional diffusion mapping (fDM) is a cancer imaging technique that quantifies voxelwise changes in apparent diffusion coefficient (ADC). Previous studies have shown value of fDMs in bevacizumab therapy for recurrent glioblastoma multiforme (GBM). The aim of the present study was to implement explicit criteria for diffusion MRI quality control and independently evaluate fDM performance in a multicenter clinical trial (RTOG 0625/ACRIN 6677). A total of 123 patients were enrolled in the current multicenter trial and signed institutional review board-approved informed consent at their respective institutions. MRI was acquired prior to and 8 weeks following therapy. A 5-point QC scoring system was used to evaluate DWI quality. fDM performance was evaluated according to the correlation of these metrics with PFS and OS at the first follow-up time-point. Results showed ADC variability of 7.3% in NAWM and 10.5% in CSF. A total of 68% of patients had usable DWI data and 47% of patients had high quality DWI data when also excluding patients that progressed before the first follow-up. fDM performance was improved by using only the highest quality DWI. High pre-treatment contrast enhancing tumor volume was associated with shorter PFS and OS. A high volume fraction of increasing ADC after therapy was associated with shorter PFS, while a high volume fraction of decreasing ADC was associated with shorter OS. In summary, DWI in multicenter trials are currently of limited value due to image quality. Improvements in consistency of image quality in multicenter trials are necessary for further advancement of DWI biomarkers.
KW - Bevacizumab
KW - Diffusion MRI
KW - Functional diffusion mapping
KW - Functional diffusion maps
KW - Glioblastoma
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=84925423430&partnerID=8YFLogxK
U2 - 10.3892/ijo.2015.2891
DO - 10.3892/ijo.2015.2891
M3 - Article
C2 - 25672376
AN - SCOPUS:84925423430
SN - 1019-6439
VL - 46
SP - 1883
EP - 1892
JO - International journal of oncology
JF - International journal of oncology
IS - 5
ER -