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Short-interval estimation of proliferation rate using serial diffusion MRI predicts progression-free survival in newly diagnosed glioblastoma treated with radiochemotherapy.

Abstract
Cell invasion, motility, and proliferation level estimate (CIMPLE) mapping is a new imaging technique that provides parametric maps of microscopic invasion and proliferation rate estimates using serial diffusion MRI data. However, a few practical constraints have limited the use of CIMPLE maps as a tool for estimating these dynamic parameters, particularly during short-interval follow-up times. The purpose of the current study was to develop an approximation for the CIMPLE map solution for short-interval scanning involving the assumption that net intervoxel tumor invasion does not occur within sufficiently short time frames. Proliferation rate maps created using the "no invasion" approximation were found to be increasingly similar to maps created from full solution during increasingly longer follow-up intervals (3D cross correlation, R (2) = 0.5298, P = 0.0001). Results also indicate proliferation rate maps from the "no invasion" approximation had significantly higher sensitivity (82 vs. 64%) and specificity (90 vs. 80%) for predicting 6 month progression free survival and was a better predictor of time to progression during standard radiochemotherapy compared to the full CIMPLE solution (log-rank; no invasion estimation, P = 0.0134; full solution, P = 0.0555). Together, results suggest the "no invasion" approximation allows for quick estimation of proliferation rate using diffusion MRI data obtained from multiple scans obtained daily or biweekly for use in quantifying early treatment response.
AuthorsTaryar M Zaw, Whitney B Pope, Timothy F Cloughesy, Albert Lai, Phioanh L Nghiemphu, Benjamin M Ellingson
JournalJournal of neuro-oncology (J Neurooncol) Vol. 116 Issue 3 Pg. 601-8 (Feb 2014) ISSN: 1573-7373 [Electronic] United States
PMID24395348 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Topics
  • Area Under Curve
  • Brain Neoplasms (pathology, therapy)
  • Cell Proliferation
  • Chemoradiotherapy
  • Diffusion Magnetic Resonance Imaging
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Glioblastoma (pathology, therapy)
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Predictive Value of Tests
  • Time Factors
  • Treatment Outcome

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