Ho Sung Kim, Presenter: Nothing to Disclose

Namkug Kim PhD, Abstract Co-Author: Nothing to Disclose

Choong Gon Choi MD, Abstract Co-Author: Nothing to Disclose

Sang Joon Kim MD, Abstract Co-Author: Nothing to Disclose

To determine whether the perfusion (f) and true diffusion (D) parameters derived from intravoxel incoherent motion (IVIM) MR imaging can be an imaging biomarker for distinguishing recurrent glioblastoma (RGM) from radiation necrosis (RN) and to compare its diagnostic accuracy with normalized cerebral blood volume (nCBV) derived from dynamic susceptibility contrast MR perfusion imaging.

Our institutional review board approved this retrospective study. Forty-seven consecutive patients with pathologically confirmed RGM (n=27, 57.4%) or RN (n=20, 42.6%) were assessed using IVIM MR imaging. The 90th and 10th percentile cumulative histogram cutoffs for the f, D, and apparent diffusion coefficient (ADC) (f90, D10, and ADC10) were calculated respectively and then correlated with the final pathology. The best predictor for differentiating RGM from RN was determined by receiver operating characteristic (ROC) curve analyses. The f90 was correlated with nCBV90 using Pearson's correlation analysis.

The mean f90 was significantly higher in the RGM group (0.091 ± 0.014) than in the RN group (0.047 ± 0.019) (p < 0.0001). The mean D10 was significantly lower in the RGM group than in the RN group (P = 0.021). ROC curve analyses showed f90 to be an excellent predictor for differentiating RGM from RN, with a sensitivity of 93.6% and a specificity of 87.9%. There was a significant positive correlation between f90 and nCBV90 for all cases (r =0.729; P < 0.0001).

A histogram analysis of IVIM perfusion and diffusion parameters can be a potential, noninvasive imaging biomarker for differentiating RGM form RN.

Intravoxel incoherent motion (IVIM) MR imaging can simulatenously measure the diffusion and perfusion characteristics of posttreatment glioblastomas without administration of contrast material.

Kim, H, Kim, N, Choi, C, Kim, S, Histogram Analysis of Intravoxel Incoherent Motion in Patients with Recurrent Glioblastoma: Initial Experience.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13019356.html