Jai Shankar, Nikunj Patil, Marco Ayroso, Roman Marin, Marc Del Bigio, Marshall Pitz, Jason Beiko, Joseph Silvaggio, Marco Essig, Saranya Kakumanu, Namita Sinha
{"title":"Isolated restricted diffusion in glioblastoma: incidence, progression, and survival impact '.","authors":"Jai Shankar, Nikunj Patil, Marco Ayroso, Roman Marin, Marc Del Bigio, Marshall Pitz, Jason Beiko, Joseph Silvaggio, Marco Essig, Saranya Kakumanu, Namita Sinha","doi":"10.1007/s00234-025-03672-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GB) is the most malignant primary brain tumor. Isolated restricted diffusion (IRD) is restricted diffusion outside the confines of enhancing tumor with no corresponding enhancement on post contrast study. The aim of our study was to prospectively assess the incidence of IRD in GB patients, determine how often these foci proceed to contrast enhancement on follow up, and analyze the survival pattern of patients with IRD.</p><p><strong>Methods: </strong>In a prospective pilot cohort study, consecutive adult patients (≥ 18 years old) suspected of having GB on initial MRI of brain, were included and screened for the presence of IRD. All images were independently analyzed by two experienced radiologists for inter-rater reliability. The survival pattern of patients with IRD was assessed with Cox-regression and Kaplan-Meier curve analysis.</p><p><strong>Results: </strong>Of the 52 patients (median age- 63 years; male-63.5%) included, 21% (11 of 52) exhibited foci of IRD. Inter-rater agreement on the diagnosis of IRD foci was fair (kappa = 0.29) between the two readers. Among the 11 patients with IRD, only 7 (64%) showed enhancement in the IRD focus on imaging at a median follow up time of 110 days. The Kaplan Meier analysis revealed a significant decrease (p = 0.035) in the survival among patients with IRD focus.</p><p><strong>Conclusion: </strong>In conclusion, IRD foci were seen in 21% of patients with GB, with 64% of these demonstrating enhancement at the IRD focus on follow up imaging. A shorter survival was associated with IRD foci.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03672-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Glioblastoma (GB) is the most malignant primary brain tumor. Isolated restricted diffusion (IRD) is restricted diffusion outside the confines of enhancing tumor with no corresponding enhancement on post contrast study. The aim of our study was to prospectively assess the incidence of IRD in GB patients, determine how often these foci proceed to contrast enhancement on follow up, and analyze the survival pattern of patients with IRD.
Methods: In a prospective pilot cohort study, consecutive adult patients (≥ 18 years old) suspected of having GB on initial MRI of brain, were included and screened for the presence of IRD. All images were independently analyzed by two experienced radiologists for inter-rater reliability. The survival pattern of patients with IRD was assessed with Cox-regression and Kaplan-Meier curve analysis.
Results: Of the 52 patients (median age- 63 years; male-63.5%) included, 21% (11 of 52) exhibited foci of IRD. Inter-rater agreement on the diagnosis of IRD foci was fair (kappa = 0.29) between the two readers. Among the 11 patients with IRD, only 7 (64%) showed enhancement in the IRD focus on imaging at a median follow up time of 110 days. The Kaplan Meier analysis revealed a significant decrease (p = 0.035) in the survival among patients with IRD focus.
Conclusion: In conclusion, IRD foci were seen in 21% of patients with GB, with 64% of these demonstrating enhancement at the IRD focus on follow up imaging. A shorter survival was associated with IRD foci.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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