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Mapping early tumor response to radiotherapy using diffusion kurtosis imaging*.

Mohammed Goryawala1, Eric A Mellon2, Hyunsuk Shim3

  • 1Department of Radiology, 12235University of Miami, Miami, FL, USA.

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|August 24, 2022
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Summary

This pilot study found that changes in axial diffusivity (AD) and axial kurtosis (AK) after two weeks of radiotherapy can predict glioblastoma treatment response. AK showed higher sensitivity in detecting early tumor changes.

Keywords:
diffusion kurtosis imaging (DKI)magnetic resonance spectroscopic imaging (MRSI)progression-free survival (PFS)receiver operating characteristic (ROC)tumor response

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Area of Science:

  • Neuro-oncology
  • Radiomics
  • Diffusion Tensor Imaging (DTI)

Background:

  • Glioblastoma is an aggressive brain tumor with poor prognosis.
  • Early prediction of treatment response is crucial for optimizing glioblastoma therapy.
  • Diffusion Tensor Imaging (DTI) metrics offer potential for non-invasive tumor assessment.

Purpose of the Study:

  • To compare DKI measures of diffusivity and kurtosis in active tumor regions.
  • To correlate these measures with radiologic response to radiotherapy after 2 weeks of treatment.
  • To derive potential early indicators of tumor response in glioblastoma patients.

Main Methods:

  • Acquired MRI and MRSI data from 14 glioblastoma patients pre- and during-radiotherapy (RT).
  • Calculated diffusivity (MD, AD, RD) and kurtosis (MK, AK, RK) values in active tumor regions.
  • Utilized ROC analysis to assess the predictive capability of diffusion metric changes for progression-free survival (PFS).

Main Results:

  • Significant differences observed in axial diffusivity (AD) (p=0.035) and axial kurtosis (AK) (p=0.019) after 2 weeks of RT.
  • Percentage change in AK demonstrated a high Area Under the Curve (AUC=0.762) in discriminating responders from non-responders.
  • Percentage change in AD also showed predictive capability (AUC=0.524).

Conclusions:

  • Early changes in AD and AK maps after 2 weeks of RT are significant in glioblastoma.
  • Kurtosis-derived AK maps show increased sensitivity for detecting early changes in active tumor regions.
  • These findings suggest potential for AK as an early biomarker for glioblastoma treatment response.