Perilesional apparent diffusion coefficient in the preoperative evaluation of glioma grade

Prognostic Value of Apparent Diffusion Coefficient (ADC) in Patients with Diffuse Gliomas

This study aimed to evaluate potential posttreatment changes in ADC values within the tissue surrounding the enhancing lesion, particularly in areas not exhibiting MRI characteristics of involvement. Additionally, the objective was to investigate the correlations among ADC values, treatment response, and survival outcomes in individuals diagnosed with gliomas. This retrospective study included a total of 49 patients that underwent either stereotactic biopsy or maximal surgical resection. Histologically confirmed as Grade III or IV gliomas, all cases adhered to the 2016 and 2021 WHO classifications, with subsequent radio-chemotherapy administered post-surgery. Patients were divided into two groups: short and long survival groups. Baseline and follow-up MRI scans were obtained on a 1.5 T MRI scanner. Two ROI circles were positioned near the enhancing area, one ROI in the NAWM ipsilateral to the neoplasm and another symmetrically in the contralateral hemisphere on ADC maps. At follow-up there was a significant difference in both ipsilateral and contralateral NAWM between the two groups, -0.0857 (p = 0.004) and -0.0607 (p = 0.037), respectively. There was a weak negative correlation between survival and ADC values in ipsilateral and contralateral NAWM at the baseline with the correlation coefficient -0.328 (p = 0.02) and -0.302 (p = 0.04), respectively. The correlation was stronger at the follow-up. The findings indicate that ADC values in normal-appearing white matter (NAWM) may function as a prognostic biomarker in patients with diffuse gliomas.

Transferrin receptor 1 targeted optical imaging for identifying glioma margin in mouse models

OBJECTIVE

Optical molecular imaging technology that indiscriminately detects intracranial glioblastoma (GBM) can help neurosurgeons effectively remove tumor masses. Transferrin receptor 1 (TfR 1) is a diagnostic and therapeutic target in GBM. A TfR 1-targeted peptide, CRTIGPSVC (CRT), was shown to cross the blood brain barrier (BBB) and accumulate at high levels in GBM tissues. In this study, we synthesized a TfR 1-targeted near-infrared fluorescent (NIRF) probe, Cy5-CRT, for identifying the GBM tissue margin in mouse models.

METHODS

We initially confirmed the overexpression of TfR 1 in GBM and the tumor-specific homing ability of Cy5-CRT in subcutaneous and orthotopic GBM mouse models. We then examined the feasibility of Cy5-CRT for identifying the tumor margin in orthotopic GBM xenografts. Finally, we compared Cy5-CRT with the clinically used fluorescein sodium in identifying tumor margins.

RESULTS

Cy5-CRT specifically accumulated in GBM tissues and detected the tumor burden with exceptional contrast in mice with orthotopic GBM, enabling fluorescence-guided GBM resection under NIRF live imaging conditions. Importantly, Cy5-CRT recognized the GBM tissue margin more clearly than fluorescein sodium.

CONCLUSIONS

The TfR 1-targeted optical probe Cy5-CRT specifically differentiates tumor tissues from the surrounding normal brain with high sensitivity, indicating its potential application for the precise surgical removal of GBM.

Associations Between Apparent Diffusion Coefficient Value With Pathological Type, Histologic Grade, and Presence of Lymph Node Metastases of Esophageal Carcinoma

Objective:

To investigate the application value of apparent diffusion coefficient value in the pathological type, histologic grade, and presence of lymph node metastases of esophageal carcinoma.

Materials and Methods:

Eighty-six patients with pathologically confirmed esophageal carcinoma were divided into different groups according to pathological type, histological grade, and lymph node status. All patients underwent conventional magnetic resonance imaging and diffusion-weighted imaging scan, and apparent diffusion coefficient values of tumors were measured. Independent sample t test and 1-way variance were used to compare the difference of apparent diffusion coefficient value in different pathological types, histologic grades, and lymph node status. Correlation between the apparent diffusion coefficient value and the histologic grade was evaluated using Spearman rank correlation test. Receiver operating characteristic curve of apparent diffusion coefficient value was generated to evaluate the differential diagnostic efficiency of poorly and well/moderately differentiated esophageal carcinoma.

Results:

No significant difference was observed in apparent diffusion coefficient value between esophageal squamous cell carcinoma and adenocarcinoma and in patients between those with and without lymph node metastases (P > .05). The differences of apparent diffusion coefficient value were statistically significant between different histologic grades of esophageal carcinoma (P < .05). The apparent diffusion coefficient value was positively correlated with histologic grade (rs = 0.802). The apparent diffusion coefficient value ≤1.25 × 10⁻³ mm²/s as the cutoff value for diagnosis of poorly differentiated esophageal carcinoma with the sensitivity of 84.3%, and the specificity was 94.3%.

Conclusions:

The performance of apparent diffusion coefficient value was contributing to predict the histologic grade of esophageal carcinoma, which might increase lesions characterization before choosing the best therapeutic alternative. However, they do not correlate with pathological type and the presence of lymph node metastases of esophageal carcinoma.