Intravoxel Incoherent Motion Metrics as Potential Biomarkers for Survival in Glioblastoma
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Updated: Mar 18, 2026

Author Spotlight: Multimodal Imaging Strategies for Optimizing Drug Delivery and Early Detection in Glioblastoma Treatment
Published on: March 1, 2024
Josep Puig1, Javier Sánchez-González2, Gerard Blasco1
1Imaging Research Unit, Institut de Diagnostic per la Imatge (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari Dr Josep Trueta, Girona, Spain.
Objective:
Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma.
Methods:
Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses.
Results:
We found that fCER and D*CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D*CER>21.712 x10-3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162-25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy.
Conclusions:
The IVIM-metrics fCER and D*CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.
Insights
Intravoxel incoherent motion (IVIM) MRI metrics, specifically perfusion fraction (f) and pseudodiffusion coefficient (D*) in contrast-enhancing regions, show promise for predicting 6-month survival in glioblastoma patients. Combining these IVIM metrics with treatment information offers high accuracy in survival prediction.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Intravoxel incoherent motion (IVIM) MRI is a technique for measuring brain tumor perfusion.
- Its clinical utility in predicting glioblastoma survival requires further investigation.
Purpose of the Study:
- To assess the effectiveness of IVIM-derived metrics in predicting survival for patients with newly diagnosed glioblastoma.
- To identify specific IVIM parameters and their thresholds associated with 6-month survival.
Main Methods:
- Fifteen glioblastoma patients underwent MRI with diffusion-weighted imaging (DWI) at 13 b-values.
- Parametric maps of diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were generated for contrast-enhancing (CER) and non-enhancing (NCER) regions.
- Kaplan-Meier and Cox proportional hazards analyses were used to evaluate prognostic factors.
Main Results:
- Perfusion fraction in contrast-enhancing regions (fCER) and pseudodiffusion coefficient in contrast-enhancing regions (D*CER) correlated with cerebral blood volume.
- Optimal cutoffs for 6-month survival were identified as fCER > 9.86% and D*CER > 21.712 x10-3mm2/s.
- Treatment was a significant prognostic factor (HR=5.484), and fCER combined with treatment predicted survival with 100% accuracy.
Conclusions:
- IVIM-derived metrics, fCER and D*CER, are valuable biomarkers for predicting 6-month survival in newly diagnosed glioblastoma.
- These IVIM parameters hold potential for clinical application in glioblastoma prognosis.
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