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Apparent diffusion coefficient as a prognostic factor in clival chordoma.

Hyeong-Cheol Oh1, Chang-Ki Hong1, Kyu-Sung Lee1

  • 1Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.

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|January 13, 2021
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Summary

Preoperative apparent diffusion coefficient (ADC) values can predict clival chordoma aggressiveness. Lower ADC values indicate a higher risk of tumor progression and recurrence, aiding in treatment planning.

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Area of Science:

  • Radiology
  • Oncology
  • Neurosurgery

Background:

  • Clival chordoma is a rare tumor with high recurrence rates despite standard treatments.
  • Apparent diffusion coefficient (ADC) has shown potential in assessing tumor aggressiveness.
  • Specific utility of ADC for clival chordoma remains underexplored.

Purpose of the Study:

  • To analyze the utility of preoperative apparent diffusion coefficient (ADC) values for predicting tumor progression and recurrence in clival chordoma patients.
  • To establish ADC cutoff values for identifying aggressive clival chordoma features.

Main Methods:

  • Retrospective analysis of 30 clival chordoma patients with preoperative ADC data (2012-2019).
  • Receiver operating characteristic (ROC) analysis to determine ADC cutoff values for tumor aggressiveness.
  • Correlation of ADC values and surgical extent with overall survival and progression-free survival.

Main Results:

  • Significantly lower mean and minimum ADC values were observed in aggressive tumors compared to stable tumors (P < 0.001).
  • Established cutoff values: mean ADC of 1198 × 10-6 mm2/s and minimum ADC of 895.5 × 10-6 mm2/s for predicting aggressiveness.
  • Lower ADC values, subtotal, and partial resections were negative predictors for survival outcomes.

Conclusions:

  • Preoperative mean and minimum ADC values are valuable tools for predicting the aggressiveness of clival chordoma.
  • ADC measurements can assist in risk stratification and personalized treatment strategies for clival chordoma.