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Apparent diffusion coefficient in glioblastoma with PNET-like components, a GBM variant
Saad Ali1, Nancy M Joseph, Arie Perry
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, Room L-358, Box 0628, San Francisco, CA, 94143, USA, saad.ali@ucsf.edu.
Journal of Neuro-Oncology
|June 5, 2014
Summary
Glioblastoma with primitive neuroectodermal tumor-like components show significantly reduced diffusion on MRI compared to conventional glioblastoma. This finding may help identify these rare tumors and guide treatment.
Area of Science:
- Neuro-oncology
- Radiology
- Pathology
Background:
- Glioblastoma with primitive neuroectodermal tumor-like (GBM-PNET) components is a rare GBM variant.
- These tumors exhibit PNET-like behavior, including increased cerebrospinal fluid (CSF) dissemination and potential benefit from PNET-like chemotherapy.
- The imaging characteristics of GBM-PNET, particularly diffusion on MRI, are not well-established.
Purpose of the Study:
- To quantitatively evaluate diffusion characteristics in GBM-PNET using MRI.
- To compare diffusion values between GBM-PNET and conventional Glioblastoma (GBM).
Main Methods:
- Retrospective analysis of MRI from nine patients with pathologically confirmed GBM-PNET.
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values were measured within tumors.
- ADC values were compared to previously published data from conventional GBM cases.
Main Results:
- GBM-PNET demonstrated substantially reduced ADC values (mean 581 × 10(-6) mm(2)/s) compared to conventional GBM (mean 1,030 × 10(-6) mm(2)/s).
- Reduced diffusion was observed in GBM-PNET compared to the enhancing components of conventional GBMs.
Conclusions:
- Significantly reduced ADC values on MRI may help identify GBM-PNET.
- MRI findings of marked restricted diffusion in suspected GBM could prompt a search for PNET-like components.
- These patients may benefit from PNET-like platinum-based chemotherapy due to increased CSF dissemination risk.
