TY - JOUR
T1 - Role of the apparent diffusion coefficient as a predictor of tumor progression in patients with chordoma
AU - Sasaki, T.
AU - Moritani, T.
AU - Belay, A.
AU - Capizzano, A. A.
AU - Sato, S. P.
AU - Sato, Y.
AU - Kirby, P.
AU - Ishitoya, S.
AU - Oya, A.
AU - Toda, M.
AU - Takahashi, K.
N1 - Funding Information:
This work was supported by the Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research Grant No. JP15K19762 (T.S.).
Publisher Copyright:
© 2018 American Society of Neuroradiology. All Rights Reserved.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - BACKGROUND AND PURPOSE: Diffusion-weighted imaging may aid in distinguishing aggressive chordoma from nonaggressive chordoma. This study explores the prognostic role of the apparent diffusion coefficient in chordomas. MATERIALS AND METHODS: Sixteen patients with residual or recurrent chordoma were divided postoperatively into those with an aggressive tumor, defined as a growing tumor having a doubling time of 1 year, and those with a nonaggressive tumor on follow-up MR images. The ability of the ADC to predict an aggressive tumor phenotype was investigated by receiver operating characteristic analysis. The prognostic role of ADC was assessed using a Kaplan-Meier curve with a log-rank test. RESULTS: Seven patients died during a median follow-up of 48 months (range, 4 -126 months). Five of these 7 patients were in the aggressive tumor group, and 2 were in the nonaggressive tumor group. The mean ADC was significantly lower in the aggressive tumor group than in the nonaggressive tumor group (P .002). Receiver operating characteristic analysis showed that a cutoff ADC value of 1.494 103 mm2/s could be used to diagnose aggressive tumors with an area under the curve of 0.983 (95% CI, 0.911-1.000), a sensitivity of 1.000 (95% CI, 0.541-1.000), and a specificity of 0.900 (95% CI, 0.555- 0.998). Furthermore, a cutoff ADC of 1.494 103 mm2/s was associated with a significantly worse prognosis (P .006). CONCLUSIONS: Lower ADC values could predict tumor progression in postoperative chordomas.
AB - BACKGROUND AND PURPOSE: Diffusion-weighted imaging may aid in distinguishing aggressive chordoma from nonaggressive chordoma. This study explores the prognostic role of the apparent diffusion coefficient in chordomas. MATERIALS AND METHODS: Sixteen patients with residual or recurrent chordoma were divided postoperatively into those with an aggressive tumor, defined as a growing tumor having a doubling time of 1 year, and those with a nonaggressive tumor on follow-up MR images. The ability of the ADC to predict an aggressive tumor phenotype was investigated by receiver operating characteristic analysis. The prognostic role of ADC was assessed using a Kaplan-Meier curve with a log-rank test. RESULTS: Seven patients died during a median follow-up of 48 months (range, 4 -126 months). Five of these 7 patients were in the aggressive tumor group, and 2 were in the nonaggressive tumor group. The mean ADC was significantly lower in the aggressive tumor group than in the nonaggressive tumor group (P .002). Receiver operating characteristic analysis showed that a cutoff ADC value of 1.494 103 mm2/s could be used to diagnose aggressive tumors with an area under the curve of 0.983 (95% CI, 0.911-1.000), a sensitivity of 1.000 (95% CI, 0.541-1.000), and a specificity of 0.900 (95% CI, 0.555- 0.998). Furthermore, a cutoff ADC of 1.494 103 mm2/s was associated with a significantly worse prognosis (P .006). CONCLUSIONS: Lower ADC values could predict tumor progression in postoperative chordomas.
UR - http://www.scopus.com/inward/record.url?scp=85049833342&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049833342&partnerID=8YFLogxK
U2 - 10.3174/ajnr.A5664
DO - 10.3174/ajnr.A5664
M3 - Article
C2 - 29724767
AN - SCOPUS:85049833342
SN - 0195-6108
VL - 39
SP - 1316
EP - 1321
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 7
ER -