Does the application of diffusion weighted imaging improve the prediction of survival in patients with resected brain metastases? A retrospective multicenter study



Zakaria, Rasheed ORCID: 0000-0001-6826-2662, Chen, Yin Jie, Hughes, David M ORCID: 0000-0002-1287-9994, Wang, Sumei, Chawla, Sanjeev, Poptani, Harish ORCID: 0000-0002-0593-3235, Berghoff, Anna S, Preusser, Matthias, Jenkinson, Michael D ORCID: 0000-0003-4587-2139 and Mohan, Suyash
(2020) Does the application of diffusion weighted imaging improve the prediction of survival in patients with resected brain metastases? A retrospective multicenter study. CANCER IMAGING, 20 (1). 16-.

Access the full-text of this item by clicking on the Open Access link.
[img] Text
2020_DWI and mets survival_multi-centre.pdf - Published version

Download (741kB) | Preview

Abstract

<h4>Background</h4>Brain metastases are common in clinical practice. Many clinical scales exist for predicting survival and hence deciding on best treatment but none are individualised and none use quantitative imaging parameters. A multicenter study was carried out to evaluate the prognostic utility of a simple diffusion weighted MRI parameter, tumor apparent diffusion coefficient (ADC).<h4>Methods</h4>A retrospective analysis of imaging and clinical data was performed on a cohort of 223 adult patients over a ten-year period 2002-2012 pooled from three institutions. All patients underwent surgical resection with histologically confirmed brain metastases and received adjuvant whole brain radiotherapy and/or chemotherapy. Survival was modelled using standard clinical variables and statistically compared with and without the addition of tumor ADC.<h4>Results</h4>The median overall survival was 9.6 months (95% CI 7.5-11.7) for this cohort. Greater age (p = 0.002), worse performance status (p < 0.0001) and uncontrolled extracranial disease (p < 0.0001) were all significantly associated with shorter survival in univariate analysis. Adjuvant whole brain radiotherapy (p = 0.007) and higher tumor ADC (p < 0.001) were associated with prolonged survival. Combining values of tumor ADC with conventional clinical scoring systems such as the Graded Prognostic Assessment (GPA) score significantly improved the modelling of survival (e.g. concordance increased from 0.5956 to 0.6277 with Akaike's Information Criterion reduced from 1335 to 1324).<h4>Conclusions</h4>Combining advanced MRI readings such as tumor ADC with clinical scoring systems is a potentially simple method for improving and individualising the estimation of survival in patients having surgery for brain metastases.

Item Type: Article
Uncontrolled Keywords: Brain metastasis, Cerebral metastasis, Diffusion MRI, DWI, Biomarkers, Survival modelling, Personalised medicine
Depositing User: Symplectic Admin
Date Deposited: 14 Feb 2020 11:01
Last Modified: 25 Jan 2024 10:12
DOI: 10.1186/s40644-020-0295-4
Open Access URL: http://doi.org/10.1186/s40644-020-0295-4
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3074878