TY - JOUR
T1 - Apparent diffusion coefficient histogram analysis stratifies progression-free and overall survival in patients with recurrent GBM treated with bevacizumab
T2 - A multi-center study
AU - Pope, Whitney B.
AU - Qiao, Xin Joe
AU - Kim, Hyun J.
AU - Lai, Albert
AU - Nghiemphu, Phioanh
AU - Xue, Xi
AU - Ellingson, Benjamin M.
AU - Schiff, David
AU - Aregawi, Dawit
AU - Cha, Soonmee
AU - Puduvalli, Vinay K.
AU - Wu, Jing
AU - Yung, Wai Kwan A.
AU - Young, Geoffrey S.
AU - Vredenburgh, James
AU - Barboriak, Dan
AU - Abrey, Lauren E.
AU - Mikkelsen, Tom
AU - Jain, Rajan
AU - Paleologos, Nina A.
AU - Rn, Patricia Lada
AU - Prados, Michael
AU - Goldin, Jonathan
AU - Wen, Patrick Y.
AU - Cloughesy, Timothy
PY - 2012/7
Y1 - 2012/7
N2 - 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.
AB - 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.
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U2 - 10.1007/s11060-012-0847-y
DO - 10.1007/s11060-012-0847-y
M3 - Article
C2 - 22426926
AN - SCOPUS:84864051629
SN - 0167-594X
VL - 108
SP - 491
EP - 498
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 3
ER -