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Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study.

Publication ,  Journal Article
Pope, WB; Qiao, XJ; Kim, HJ; Lai, A; Nghiemphu, P; Xue, X; Ellingson, BM; Schiff, D; Aregawi, D; Cha, S; Puduvalli, VK; Wu, J; Yung, W-KA ...
Published in: J Neurooncol
July 2012

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 × 10(-6)mm(2)/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 multi-center (BRAIN) study.

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Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

July 2012

Volume

108

Issue

3

Start / End Page

491 / 498

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Humans
  • Glioblastoma
  • Female
 

Citation

APA
Chicago
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Pope, W. B., Qiao, X. J., Kim, H. J., Lai, A., Nghiemphu, P., Xue, X., … Cloughesy, T. (2012). Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study. J Neurooncol, 108(3), 491–498. https://doi.org/10.1007/s11060-012-0847-y
Pope, Whitney B., Xin Joe Qiao, Hyun J. Kim, Albert Lai, Phioanh Nghiemphu, Xi Xue, Benjamin M. Ellingson, et al. “Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study.J Neurooncol 108, no. 3 (July 2012): 491–98. https://doi.org/10.1007/s11060-012-0847-y.
Pope, Whitney B., et al. “Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study.J Neurooncol, vol. 108, no. 3, July 2012, pp. 491–98. Pubmed, doi:10.1007/s11060-012-0847-y.
Pope WB, Qiao XJ, Kim HJ, Lai A, Nghiemphu P, Xue X, Ellingson BM, Schiff D, Aregawi D, Cha S, Puduvalli VK, Wu J, Yung W-KA, Young GS, Vredenburgh J, Barboriak D, Abrey LE, Mikkelsen T, Jain R, Paleologos NA, Lada P, Prados M, Goldin J, Wen PY, Cloughesy T. Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab: a multi-center study. J Neurooncol. 2012 Jul;108(3):491–498.
Journal cover image

Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

July 2012

Volume

108

Issue

3

Start / End Page

491 / 498

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Humans
  • Glioblastoma
  • Female