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RT Journal Article
SR Electronic
T1 Role of the Apparent Diffusion Coefficient as a Predictor of Tumor Progression in Patients with Chordoma
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1316
OP 1321
DO 10.3174/ajnr.A5664
VO 39
IS 7
A1 Sasaki, T.
A1 Moritani, T.
A1 Belay, A.
A1 Capizzano, A.A.
A1 Sato, S.P.
A1 Sato, Y.
A1 Kirby, P.
A1 Ishitoya, S.
A1 Oya, A.
A1 Toda, M.
A1 Takahashi, K.
YR 2018
UL http://www.ajnr.org/content/39/7/1316.abstract
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 &lt;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 × 10−3 × 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 × 10−3 × mm2/s was associated with a significantly worse prognosis (P = .006).CONCLUSIONS: Lower ADC values could predict tumor progression in postoperative chordomas.RTradiotherapy