Survival analysis for apparent diffusion coefficient measures in children with embryonal brain tumours

Area of Science:

• Neuro-oncology
• Radiology
• Pediatric Oncology

Background:

• Embryonal brain tumors are a significant challenge in pediatric neuro-oncology.
• Apparent diffusion coefficient (ADC) measures have shown utility in tumor analysis.
• A novel ADC-derived parameter, apparent transient coefficient in tumor (ATCT), warrants investigation for prognostic value.

Purpose of the Study:

• To evaluate the correlation between the apparent transient coefficient in tumor (ATCT) and survival outcomes in pediatric embryonal brain tumors.
• To determine if ATCT is an independent predictor of survival in this patient cohort.

Main Methods:

• Retrospective analysis of 61 patients with embryonal brain tumors who underwent diffusion-weighted imaging (DWI).
• Calculation of ATCT, a measure of ADC gradient from peri-tumoral edema to tumor core.
• Kaplan-Meier and multivariate survival analyses incorporating ATCT and other clinical variables.

Main Results:

• Multivariate analysis identified ATCT as the sole significant independent covariate for survival (P < .001).
• Survival analysis demonstrated that more negative ATCT values were significantly associated with poorer prognosis (P < .001).
• A significant difference in survival was observed based on the ADC change from edema to tumor volume.

Conclusions:

• The apparent transient coefficient in tumor (ATCT) is a significant independent predictor of survival in pediatric embryonal brain tumors.
• Negative ATCT values indicate a poorer prognosis, irrespective of tumor type, surgical extent, age, or metastasis.
• ATCT offers a novel, non-invasive imaging biomarker for stratifying risk in these young patients.