Monitoring Glioma Recurrence And Treatment Effect With Intravoxel Ncoherent Motion(IVIM): Initial Clinical Experience

Purpose: To evaluate the value of intravoxel incoherent motion(IVIM)in monitoring the glioma recurrence and treatment effect.Methods: Twenty-six patients with surgically treated primary gliomas and with concurrent radiotherapy and chemotherapy were collected(15 cases of glioma recurrence,11 cases of reatment effect),ranging from October 2015 to December 2016 in First Hospital of Shanxi Medical Unversity.All patients underwent conventional MR scan,enhanced scan and multi-b the value dispersion weighted imaging at the end of the 2 months of concurrent radiotherapy and chemotherapy,We can get the parameter image of standard ADC,slow ADC(D),fast ADC(D*),fraction of fast ADC(f)through the double exponential model of IVIM software,the difference of standard ADC value,D value,D* value and f value of abnormal enhancement area were measured in two groups.The t test was used to compare whether the parameter value of brain glioma recurrence differed significantly from treatment effect.we described receiver operating characteristic curve(ROC)to evaluate the area under the curve(AUC),and compare the differential diagnosis value of each parameter in glioma recurrence and reatment effect.Results:(1)Standard ADC value of the enhanced lesions in glioma recurrence group(0.852±0.378)are slightly lower than that the treatment effect group(1.27±0.551),and the difference was statistically significant(P=0.031);D value of the enhanced lesions in glioma recurrence group(0.528±0.228)are slightly lower than that the treatment effect group(0.751±0.203),and the difference was statistically significant(P=0.017);D* value of the enhanced lesions in glioma recurrence group(2.91±0.62)were slightly higher than that the treatment effect group(2.42±0.34),and the difference was statistically significant(P=0.025);f value of the enhanced lesions in glioma recurrence group(0.604±0.261)were slightly higher than that the treatment effect group(0.394±0.231),and the difference was statistically significant(P=0.044).(2)ROC curve analysis showed that when the area under curve of standard ADC value and D value were 0.703 and 0.788,the threshold values were 1.166 and 0.631 respectively,the sensitivity and specificity was 54.5% and 86.7%,81.8% and 73.3% respectively,the diagnostic value of the D value is better than the standard ADC value;ROC curve analysis showed that when the area under curve of the D* values,f values were 0.752 and 0.758,the threshold values were 2.642 and 0.693 respectively,the sensitivity and specificity was 66.7% and 81.8%,81.8% and 66.7% respectively.Conclusion: IVIM can be used to monitor glioma recurrence and treatment effect,and to provide imaging evidence for the clinical treatment of patients with glioma.Conclution: IVIM can be used to monitor glioma recurrence and treatment effect,and to provide imaging evidence for the clinical treatment of patients with glioma.