title: Local Fractional Anisotropy Is Reduced in Areas with Tumor Recurrence in Glioblastoma.
abstract: Purpose To analyze if fractional anisotropy (FA) in nonenhancing peritumoral regions (NEPTRs) at baseline is associated with later tumor recurrence in glioblastoma. Materials and Methods Ethical approval was obtained for this retrospective, HIPAA-compliant study. FA was measured in 70 patients with glioblastoma in five regions of interest (ROIs) per patient in the NEPTR at preoperative magnetic resonance (MR) imaging with (166 regions) or without (184 regions) local contrast-enhancing tumor recurrence at follow-up MR imaging (median, 7.3 months; range, 0.9-46.6 months). ROIs were classified according to their location (white matter, cortex, fiber tracts, basal ganglia). Ratio of FA in the ROI of the NEPTR to that in the contralateral side (FAcontra) and to that in the internal capsule (FAint) was calculated. A generalized linear mixed model was performed. Ten-fold cross-validation was used for the receiver operating characteristics (ROC) analysis. Results FAcontraand FAintwere significantly lower in regions with later tumor recurrence than in regions without (median FAcontra: 0.29 [interquartile range {IR}, 0.22-0.36] vs 0.46 [IR, 0.38-0.57]; median FAint: 0.20 [IR, 0.16-0.24] vs 0.29 [IR, 0.22-0.36], respectively). ROC analysis revealed an area under the ROC curve of 0.893 for FAcontraand of 0.815 for FAint, resulting in respective sensitivity and specificity of 85.5% and 84.2% for FAcontraand 86.7% and 66.8% for FAint. Conclusion Local tumor recurrence in the NEPTR may be predicted by FA metrics at baseline in patients with glioblastoma. This might be important for surgery or radiation planning.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Bette
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Huber
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Jens
authors.identifier: 0000-0003-4123-4690
authors.initials: J
authors.lastname: Gempt
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Boeckh-Behrens
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Wiestler
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Victoria
authors.initials: V
authors.lastname: Kehl
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Ringel
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: From the Departments of Neuroradiology (S.B., T.H., T.B.B., B.W., C.Z., J.S.K.), Neurosurgery (J.G., F.R., B.M.), and Statistics and Epidemiology (V.K.), Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany.
authors.forename: Jan S
authors.identifier: 0000-0002-7557-0003
authors.initials: JS
authors.lastname: Kirschke
mesh_terms: D000368:Aged; D016880:Anisotropy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome