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

Simple Summary This retrospective study aimed to analyze ADC values in the tissue surrounding enhancing gliomas and in the normal-appearing white matter. The goal was to find potential correlations of these values with treatment response and survival of patients. Patients, divided into short and long survival groups, underwent stereotactic biopsy or maximal surgical resection, followed by concomitant radio-chemotherapy. Baseline and follow-up MRI scans revealed significant differences in NAWM ADC values between the groups. Overall, the study suggests that ADC values in NAWM could serve as a prognostic biomarker for diffuse glioma patients.Abstract 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.