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Updated: May 7, 2026
Digital Spatial Profiling for Characterization of the Microenvironment in Adult-Type Diffusely Infiltrating Glioma
Published on: September 13, 2022
Infiltrative patterns of glioblastoma: Identification of tumor progress using apparent diffusion coefficient
Kira Lutz1, Benedikt Wiestler, Markus Graf
1Department of Neuroradiology, University of Heidelberg, Medical Center, Heidelberg, Germany.
Purpose:
To investigate whether apparent diffusion coefficient (ADC) histogram analysis can differentiate between patients presenting T2-progress and patients presenting stable T2-signal in glioblastoma.
Materials And Methods:
Fourteen patients presenting an isolated T2-progress and a matched control group exhibiting stable disease were included. Relative ADC value distribution within tumoral and peritumoral FLAIR hyperintensities were evaluated using ADC-histogram analysis. Severity and frequency of ADC shift between baseline, T2-progress, and subsequent T1-progress were analyzed using the Wilcoxon test.
Results:
The shift of ADC histograms either to higher or to lower values in case of T2-progress was significantly more severe than in the control group (P value 0.05). Furthermore, a significant shift toward lower ADC values (P value 0.02) was detected when comparing ADC histograms of patients with T2-progress and subsequent T1-progress.
Conclusion:
The basis for the observed ADC shift in isolated T2-progress may be time dependent: Initially, formation of peritumoral edema may cause an increase of ADC values that is followed by tumor cells infiltrating the surrounding tissue, causing a subsequent decrease of ADC values. The shift toward lower ADC values in case of subsequent T1-progress confirms this hypothesis and provides further evidence for T2-progress being an intermediate step between stable disease (SD) and T1-progress.
