Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma

Ellingson,Benjamin M.; Kim,Eunhee; Woodworth,Davis C.; Marques,Helga; Boxerman,Jerrold L.; Safriel,Yair; McKinstry,Robert C.; Bokstein,Felix; Jain,Rajan; Chi,T. Linda; Sorensen,A. Gregory; Gilbert,Mark R.; Barboriak,Daniel P.

doi:10.3892/ijo.2015.2891

May-2015 Volume 46 Issue 5

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May-2015 Volume 46 Issue 5

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Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma

Authors:
- Benjamin M. Ellingson
- Eunhee Kim
- Davis C. Woodworth
- Helga Marques
- Jerrold L. Boxerman
- Yair Safriel
- Robert C. McKinstry
- Felix Bokstein
- Rajan Jain
- T. Linda Chi
- A. Gregory Sorensen
- Mark R. Gilbert
- Daniel P. Barboriak
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Affiliations: UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA, Center for Statistical Sciences, Brown University, Providence, RI, USA, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA, Department of Diagnostic Imaging, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA, Radiology Associates of Clearwater, University of South Florida, Clearwater, FL, USA, Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA, Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Israel, Departments of Radiology and Neurosurgery, Henry Ford Hospital, Detroit, MI, USA, Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, Department of Radiology, Duke University Medical Center, Durham, NC, USA

Copyright: © Ellingson et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].
Pages: 1883-1892
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Published online on: February 11, 2015

https://doi.org/10.3892/ijo.2015.2891
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Abstract

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.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma

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