Pretreatment diffusion-weighted imaging for prediction of relapsed and refractory primary central nervous system lymphoma

doi:10.3389/fneur.2023.1227607

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Title:	Pretreatment diffusion-weighted imaging for prediction of relapsed and refractory primary central nervous system lymphoma
Authors:	Chien, Hsi-Cheng Yeh, Lee-Ren Hung, Kuo-Chuan Lim, Sher-Wei Cheng, Chung-Yu Lee, Yu-Chang Chen, Jeon-Hor Ko, Ching-Chung
Contributors:	Chi Mei Med Ctr, Dept Med Imaging E Da Hosp, Dept Med Imaging I Shou Univ, Coll Med, Dept Med Imaging & Radiol Sci I Shou Univ, Coll Med, Sch Med Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Coll Recreat & Hlth Management, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Neurosurg Min Hwei Coll Hlth Care Management, Dept Nursing Univ Calif Irvine, Dept Radiol Sci Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
Keywords:	CNS lymphoma relapse refractory ADC DWI MRI
Date:	2023
Issue Date:	2024-12-25 11:04:57 (UTC+8)
Publisher:	FRONTIERS MEDIA SA
Abstract:	Objectives: A subset of primary central nervous system lymphoma (PCNSL) has been shown to undergo an early relapsed/refractory (R/R) period after first-line chemotherapy. This study investigated the pretreatment clinical and MRI features to predict R/R in PCNSL, emphasizing the apparent diffusion coefficient (ADC) values in diffusion-weighted imaging (DWI). Methods: This retrospective study investigated the pretreatment MRI features for predicting R/R in PCNSL. Only patients who had undergone complete preoperative and postoperative MRI follow-up studies were included. From January 2006 to December 2021, 52 patients from two medical institutions with a diagnosis of PCNSL were included (median follow-up time, 26.3 months). Among these, 24 (46.2%) had developed R/R (median time to relapse, 13 months). Cox proportional hazard regression analyses were performed to determine hazard ratios for all parameters. Results: Significant predictors of R/R in PCNSL were female sex, complete response (CR) to first-line chemotherapy, and ADC value/ratio (p < 0.05). Cut-off points of ADC values and ADC ratios for prediction of R/R were 0.68 x 10(-3) mm(2)/s and 0.97, with AUCs of 0.78 and 0.77, respectively (p < 0.05). Multivariate Cox proportional hazards analysis showed that failure of CR to first-line chemotherapy and low ADC values (<0.68 x 10(-3) mm(2)/s) were significant risk factors for R/R, with hazard ratios of 5.22 and 14.45, respectively (p < 0.05). Kaplan-Meier analysis showed that lower ADC values and ratios predicted significantly shorter progression-free survival (p < 0.05). Conclusion: Pretreatment ADC values in DWI offer quantitative valuable information for the treatment planning in PCNSL.
Relation:	Frontiers in Neurology, v.14, Article 1227607
Appears in Collections:	[Offices] 456

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