title: Apparent diffusion coefficient parametric response mapping MRI for follow-up of glioblastoma.
abstract: OBJECTIVE
  To determine the diagnostic superiority of parametric response mapping of apparent diffusion coefficient (ADCPR) for predicting glioblastoma treatment response, compared to single time point measurement.
  
  
  METHODS
  Fifty post-treatment glioblastoma patients were enrolled. ADCPR was calculated from serial apparent diffusion coefficient (ADC) maps acquired before and at the time of first detection of an enlarged contrast-enhancing lesion on voxel-by-voxel basis. The percentage-decrease in ADCPR and tenth percentile histogram cutoff value of ADC (ADC10) were compared at subsequent 3-month and 1-year follow-ups.
  
  
  RESULTS
  The percentage-decrease in ADCPR was significantly higher in the progression group (mean = 33.2-38.3 %) than in the stable-response group (mean = 9.7 %) at 3 months follow-up (corrected p < 0.001 for both readers). ADCPR significantly improved area under the receiver operating characteristic curve from 0.67 to 0.88 (corrected p = 0.037) and from 0.70 to 0.92 (corrected p = 0.020) for both readers, respectively, compared to ADC10 at 3-month follow-up, but did not significantly improve at 1-year follow-up. The inter-reader agreement was higher for ADCPR than ADC10 (intraclass correlation coefficient, 0.93 versus 0.86).
  
  
  CONCLUSIONS
  Voxel-based ADCPR appears to be a superior imaging biomarker than ADC, particularly for predicting early tumour progression in patients with glioblastoma.
  
  
  CONCLUSIONS
  • Treatment response pattern of glioblastoma was evaluated using voxel-based ADCPR and ADC10. • Voxel-based ADCPR was more accurate in predicting treatment response pattern than ADC10. • Inter-reader agreement was higher in ADCPR calculation than in ADC10 calculation. • Voxel-based ADCPR can be a predictor of early treatment response pattern for glioblastoma.
authors.affiliation: Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, 25, Simgok-ro 100 beon-gil, Seo-gu, Incheon, 404-834, Republic of Korea. yoonrg@hanmail.net.
authors.forename: Ra Gyoung
authors.initials: RG
authors.lastname: Yoon
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea. radhskim@gmail.com.
authors.forename: Ho Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Bundang Jesaeng Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, Republic of Korea.
authors.forename: Dae Yoon
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea.
authors.forename: Gil Sun
authors.initials: GS
authors.lastname: Hong
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea.
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping / Q000379:methods*; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Brain; Chemoradiotherapy; Glioblastoma; Magnetic resonance imaging; Response evaluation