Differentiating tumour progression from pseudoprogression in glioblastoma patients: a monoexponential, biexponential, and stretched-exponential model-based DWI study

BMC Medical Imaging

Research

Yuan-Cheng Liu¹  Jiang-Yong Liu¹  Di Wang¹  Xin-Feng Liu¹  Dan Liao² 

[1] Department of Radiology, Guizhou Provincial People’s Hospital, 550002, Guiyang, Guizhou, China;Department of Radiology, Guizhou Provincial People’s Hospital, 550002, Guiyang, Guizhou, China;Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 100010, Beijing, China;

关键词: MRI;    Glioblastoma;    Pseudoprogression;    Tumour progression;    Diffusion-weighted imaging;   

DOI  :  10.1186/s12880-023-01082-7

 received in 2022-12-10, accepted in 2023-08-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo investigate the diagnostic performance of parameters derived from monoexponential, biexponential, and stretched-exponential diffusion-weighted imaging models in differentiating tumour progression from pseudoprogression in glioblastoma patients.MethodsForty patients with pathologically confirmed glioblastoma exhibiting enhancing lesions after completion of chemoradiation therapy were enrolled in the study, which were then classified as tumour progression and pseudoprogression. All patients underwent conventional and multi-b diffusion-weighted MRI. The apparent diffusion coefficient (ADC) from a monoexponential model, the true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched-exponential model were compared between tumour progression and pseudoprogression groups. Receiver operating characteristic curves (ROC) analysis was used to investigate the diagnostic performance of different DWI parameters. Interclass correlation coefficient (ICC) was used to evaluate the consistency of measurements.ResultsThe values of ADC, D, DDC, and α values were lower in tumour progression patients than that in pseudoprogression patients (p < 0.05). The values of D* and f were higher in tumour progression patients than that in pseudoprogression patients (p < 0.05). Diagnostic accuracy for differentiating tumour progression from pseudoprogression was highest for α(AUC = 0.94) than that for ADC (AUC = 0.91), D (AUC = 0.92), D* (AUC = 0.81), f (AUC = 0.75), and DDC (AUC = 0.88).ConclusionsMulti-b DWI is a promising method for differentiating tumour progression from pseudoprogression with high diagnostic accuracy. In addition, the α derived from stretched-exponential model is the most promising DWI parameter for the prediction of tumour progression in glioblastoma patients.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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