Open Access

Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma

  • Authors:
    • Benjamin M. Ellingson
    • Eunhee Kim
    • Davis C. Woodworth
    • Helga Marques
    • Jerrold L. Boxerman
    • Yair Safriel
    • Robert C. McKinstry
    • Felix Bokstein
    • Rajan Jain
    • T. Linda Chi
    • A. Gregory Sorensen
    • Mark R. Gilbert
    • Daniel P. Barboriak
  • View Affiliations

  • Published online on: February 11, 2015     https://doi.org/10.3892/ijo.2015.2891
  • Pages: 1883-1892
  • Copyright: © Ellingson et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

Functional diffusion mapping (fDM) is a cancer imaging technique that quantifies voxelwise changes in apparent diffusion coefficient (ADC). Previous studies have shown value of fDMs in bevacizumab therapy for recurrent glioblastoma multiforme (GBM). The aim of the present study was to implement explicit criteria for diffusion MRI quality control and independently evaluate fDM performance in a multicenter clinical trial (RTOG 0625/ACRIN 6677). A total of 123 patients were enrolled in the current multicenter trial and signed institutional review board-approved informed consent at their respective institutions. MRI was acquired prior to and 8 weeks following therapy. A 5-point QC scoring system was used to evaluate DWI quality. fDM performance was evaluated according to the correlation of these metrics with PFS and OS at the first follow-up time-point. Results showed ADC variability of 7.3% in NAWM and 10.5% in CSF. A total of 68% of patients had usable DWI data and 47% of patients had high quality DWI data when also excluding patients that progressed before the first follow-up. fDM performance was improved by using only the highest quality DWI. High pre-treatment contrast enhancing tumor volume was associated with shorter PFS and OS. A high volume fraction of increasing ADC after therapy was associated with shorter PFS, while a high volume fraction of decreasing ADC was associated with shorter OS. In summary, DWI in multicenter trials are currently of limited value due to image quality. Improvements in consistency of image quality in multicenter trials are necessary for further advancement of DWI biomarkers.
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May-2015
Volume 46 Issue 5

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Ellingson BM, Kim E, Woodworth DC, Marques H, Boxerman JL, Safriel Y, McKinstry RC, Bokstein F, Jain R, Chi TL, Chi TL, et al: Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma. Int J Oncol 46: 1883-1892, 2015.
APA
Ellingson, B.M., Kim, E., Woodworth, D.C., Marques, H., Boxerman, J.L., Safriel, Y. ... Barboriak, D.P. (2015). Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma. International Journal of Oncology, 46, 1883-1892. https://doi.org/10.3892/ijo.2015.2891
MLA
Ellingson, B. M., Kim, E., Woodworth, D. C., Marques, H., Boxerman, J. L., Safriel, Y., McKinstry, R. C., Bokstein, F., Jain, R., Chi, T. L., Sorensen, A. G., Gilbert, M. R., Barboriak, D. P."Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma". International Journal of Oncology 46.5 (2015): 1883-1892.
Chicago
Ellingson, B. M., Kim, E., Woodworth, D. C., Marques, H., Boxerman, J. L., Safriel, Y., McKinstry, R. C., Bokstein, F., Jain, R., Chi, T. L., Sorensen, A. G., Gilbert, M. R., Barboriak, D. P."Diffusion MRI quality control and functional diffusion map results in ACRIN 6677/RTOG 0625: A multicenter, randomized, phase II trial of bevacizumab and chemotherapy in recurrent glioblastoma". International Journal of Oncology 46, no. 5 (2015): 1883-1892. https://doi.org/10.3892/ijo.2015.2891