Evidence map›Paper›PMID 33060101›Full record

ArticleAJNR. American journal of neuroradiology2020

Centrally Reduced Diffusion Sign for Differentiation between Treatment-Related Lesions and Glioma Progression: A Validation Study.

P Alcaide-Leon, J Cluceru, J M Lupo, T J Yu, T L Luks, T Tihan, N A Bush, J E Villanueva-Meyer

Open access · hybridAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in AJNR. American journal of neuroradiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 4 countries.

P Alcaide-LeonFrom the Department of Medical Imaging (P.A.-L.), University Health Network, Toronto, Ontario, Canada.ORCID 0000-0001-6146-7972
J CluceruDepartment of Radiology and Biomedical Imaging (J.C., J.M.L., T.J.Y., T.L.L., J.E.V.-M.).ORCID 0000-0002-3702-9080
J M LupoDepartment of Radiology and Biomedical Imaging (J.C., J.M.L., T.J.Y., T.L.L., J.E.V.-M.).ORCID 0000-0002-0051-6387
T J YuDepartment of Radiology and Biomedical Imaging (J.C., J.M.L., T.J.Y., T.L.L., J.E.V.-M.).ORCID 0000-0003-0494-9400
T L LuksDepartment of Radiology and Biomedical Imaging (J.C., J.M.L., T.J.Y., T.L.L., J.E.V.-M.).ORCID 0000-0003-0994-9960
T TihanPathology (T.T.).ORCID 0000-0003-4551-2555
N A BushNeurological Surgery (N.A.B.), University of California, San Francisco, San Francisco, California.ORCID 0000-0001-8302-5008
J E Villanueva-MeyerDepartment of Radiology and Biomedical Imaging (J.C., J.M.L., T.J.Y., T.L.L., J.E.V.-M.) javier.villanueva-meyer@ucsf.edu.ORCID 0000-0002-5910-0757
Laboratoire d’Imagerie Biomédicale · FRT3 Scientific (United States) · USUniversity Health Network · CAUniversity of California, San Francisco · US

Funding

Tissue CoreP50CA097257 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Joseph F Costello · 2002 to 2026
$57.4M
Project 4: Multi-modality Metabolic Imaging for Monitoring Molecular Sub-types of GliomaP01CA118816 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Pavithra Viswanath · 2007 to 2026
$44.7M
Training Program in Translational Brain Tumor ResearchT32CA151022 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Joseph F Costello · 2010 to 2026
$6.6M
NCI NIH HHS P01 CA118816NCI NIH HHS P50 CA097257NCI NIH HHS T32 CA151022
6 · The paper itself

Abstract

background and purposeDifferentiating between treatment-related lesions and tumor progression remains one of the greatest dilemmas in neuro-oncology. Diffusion MR imaging characteristics may provide useful information to help make this distinction. The aim of the study was to assess the diagnostic accuracy of the centrally reduced diffusion sign for differentiation of treatment-related lesions and true tumor progression in patients with suspected glioma recurrence. MATERIALS AND

methodsThe images of 231 patients who underwent an operation for suspected glioma recurrence were reviewed. Patients with susceptibility artifacts or without central necrosis were excluded. The final diagnosis was established according to histopathology reports. Two neuroradiologists classified the diffusion patterns on preoperative MR imaging as the following: 1) reduced diffusion in the solid component only, 2) reduced diffusion mainly in the solid component, 3) no reduced diffusion, 4) reduced diffusion mainly in the central necrosis, and 5) reduced diffusion in the central necrosis only. Diagnostic accuracy metrics and the area under the receiver operating characteristic curve were estimated for the diffusion patterns.

resultsOne hundred three patients were included (22 with treatment-related lesions and 81 with tumor progression). The diagnostic accuracy results for the centrally reduced diffusion pattern as a predictor of treatment-related lesions ("mainly central" and "exclusively central" patterns versus all other patterns) were as follows: 64% sensitivity (95% CI, 41%-83%), 84% specificity (95% CI, 74%-91%), 52% positive predictive value (95% CI, 37%-66%), and 89% negative predictive value (95% CI, 83%-94%).

conclusionsThe centrally reduced diffusion sign is associated with the presence of treatment effect. The probability of a histologic diagnosis of a treatment-related lesion is low (11%) in the absence of centrally reduced diffusion.

Indexed as

AdultAgedAged, 80 and overBrainBrain NeoplasmsCombined Modality TherapyDiffusion Magnetic Resonance ImagingDisease ProgressionFemaleGliomaHumansMagnetic Resonance ImagingMaleMiddle AgedNecrosisNeoplasm Recurrence, Local

Identifiers

PMID33060101
PMCPMC7658838
OpenAlexW3093401208

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.