Abstract
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. 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 <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. 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). Lower ADC values could predict tumor progression in postoperative chordomas.
Highlights
BACKGROUND AND PURPOSEDiffusion-weighted imaging may aid in distinguishing aggressive chordoma from nonaggressive chordoma
Receiver operating characteristic analysis showed that a cutoff ADC value of 1.494 ϫ 10Ϫ3 ϫ mm2/s could be used to diagnose aggressive tumors with an area under the curve of 0.983, a sensitivity of 1.000, and a specificity of 0.900
Chordoma is a rare bone tumor arising from notochordal remnants in the skull base, spine, or sacrococcygeal region.[1]
Summary
The aim of this study was to explore the role of the ADC as a predictor of outcome in patients with chordomas
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have