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Published on: September 13, 2022
Predicting Survival in Glioblastoma Patients Using Diffusion MR Imaging Metrics-A Systematic Review
Valentina Brancato1, Silvia Nuzzo1, Liberatore Tramontano1
1IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80131 Naples, Italy.
Abstract:
Despite advances in surgical and medical treatment of glioblastoma (GBM), the medium survival is about 15 months and varies significantly, with occasional longer survivors and individuals whose tumours show a significant response to therapy with respect to others. Diffusion MRI can provide a quantitative assessment of the intratumoral heterogeneity of GBM infiltration, which is of clinical significance for targeted surgery and therapy, and aimed at improving GBM patient survival. So, the aim of this systematic review is to assess the role of diffusion MRI metrics in predicting survival of patients with GBM. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature search was performed to identify original articles since 2010 that evaluated the association of diffusion MRI metrics with overall survival (OS) and progression-free survival (PFS). The quality of the included studies was evaluated using the QUIPS tool. A total of 52 articles were selected. The most examined metrics were associated with the standard Diffusion Weighted Imaging (DWI) (34 studies) and Diffusion Tensor Imaging (DTI) models (17 studies). Our findings showed that quantitative diffusion MRI metrics provide useful information for predicting survival outcomes in GBM patients, mainly in combination with other clinical and multimodality imaging parameters.
Insights
Quantitative diffusion MRI metrics can predict survival outcomes in glioblastoma (GBM) patients. Combining these metrics with other data improves prediction accuracy for better patient survival.
Area of Science:
- Radiology and Imaging Science
- Neuro-oncology
- Medical Physics
Background:
- Glioblastoma (GBM) has a poor prognosis despite treatment advances, with median survival around 15 months.
- Intratumoral heterogeneity in GBM impacts treatment response and patient survival.
- Diffusion MRI offers quantitative insights into GBM infiltration and heterogeneity.
Purpose of the Study:
- To systematically review the role of diffusion MRI metrics in predicting survival for glioblastoma patients.
- To assess the association between diffusion MRI metrics and overall survival (OS) and progression-free survival (PFS).
Main Methods:
- Systematic literature search conducted according to PRISMA guidelines, focusing on articles published since 2010.
- Included studies evaluated diffusion MRI metrics (DWI and DTI models) against OS and PFS.
- Study quality assessed using the QUIPS tool; 52 articles were selected for review.
Main Results:
- Diffusion Weighted Imaging (DWI) metrics were examined in 34 studies, and Diffusion Tensor Imaging (DTI) metrics in 17 studies.
- Quantitative diffusion MRI metrics demonstrated utility in predicting survival outcomes for GBM patients.
- The predictive power of diffusion MRI metrics is enhanced when combined with clinical data and other imaging parameters.
Conclusions:
- Diffusion MRI provides valuable quantitative information for predicting glioblastoma patient survival.
- Integration of diffusion MRI metrics with clinical and multimodality imaging data is recommended for improved prognostic accuracy.
- Further research can refine the application of diffusion MRI in personalized glioblastoma treatment strategies.
