Diffusion-weighted imaging and dynamic susceptibility contrast-enhanced perfusion-weighted imaging of the non-enhancing peritumoural region predict overall survival in glioblastoma.

AIM: To investigate the preditive value of diffusion-weighted imaging (DWI) and dynamic sensitive contrast perfusion-weighted imaging (DSC-PWI) parameters based on contrast-enhancing regions (CER) and nonenhancing peritumoural regions (NEPR) for overall survival (OS) in patients with ,isocitrate dehydrogenase 1 (IDH)-wildtype glioblastoma (GBM).

MATERIALS AND

METHODS

Adult patients with IDH-wildtype GBM who underwent gross total resection (GTR) and were histologically confirmed at our institution were retrospectively collected and followed up. Patients were categorised into two groups, short-term survivors (STS; OS ≦ 16 months, n=33) and long-term survivors (LTS; OS > 16 months, n=28). The relative minimum apparent diffusion coefficient (rADCmin-t, rADCmin-p) and relative maximum cerebral blood volume (rCBVmax-t, rCBVmax-p) in the CER and NEPR were measured and analysed via independent-samples t-test, receiver operating characteristic (ROC) curves, and Spearman correlation.

RESULTS

Compared with the LTS, the STS demonstrated lower rADCmin-p (1.35 ± 0.27 vs 1.80 ± 0.32, P < 0.001) and higher rCBVmax-p (4.46 ± 2.34 vs 2.17 ± 0.85, P < 0.001). The area under the curves (AUCs) of rADCmin-p and rCBVmax-p for OS prediction were 0.856 and 0.832, respectively, with the combined models achieving the highest AUC (0.909, P > 0.05). In contrast, there was no significant difference in rADCmin-t and rCBVmax-t of CER between the two groups (both P > 0.05).

CONCLUSION

Preoperative rADCmin-p and rCBVmax-p in NEPR serve as crucial imaging markers that correlate with long- and short-term OS in patients with IDH-wildtype GBM after GTR.