ArticleMagnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine2026
Impact of Free Water Correction on the Mean Diffusivity of Glioblastoma is Regional and b-value Dependent: A Retrospective Study on Open-source Datasets.
Article in Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the effects of free-water (FW) correction on mean diffusivity (MD) values in glioblastomas using diffusion tensor imaging (DTI) with different b-value settings. We also examined regional differences between contrast-enhanced (CE) tumor and peritumoral fluid-attenuated inversion recovery (FLAIR) hyperintense regions.
methodsDTI data from 787 participants with glioblastoma were obtained from 2 open-source datasets: the University of California, San Francisco Preoperative Diffuse Glioma MRI (UCSF-PDGM; b-value, 2000) and the Multi-parametric Magnetic Resonance Imaging Scans for De Novo Glioblastoma Patients from the University of Pennsylvania Health System (UPENN-GBM; b-value, 1000). Conventional and FW-corrected MD maps were generated, and median MD values were calculated from CE and FLAIR hyperintense regions. The impact of FW correction was assessed via the Wilcoxon matched-pairs signed rank test, Bland-Altman plot, and Spearman's correlation analysis. Multivariate Cox regression was used to evaluate prognostic significance, adjusting for age and CE volume.
resultsBoth median MD values were significantly lower in the CE regions than in the FLAIR hyperintense regions. In the UCSF-PDGM dataset, FW correction caused a greater reduction of MD in the CE regions, whereas the greater reduction occurred in the FLAIR hyperintense regions in the UPENN-GBM dataset. Bland-Altman plot also indicated lesions with lower MD values showing greater FW correction in the UCSF-PDGM dataset, whereas those with relatively high MD values showed greater FW correction in the UPENN-GBM dataset. The correlation between both MD values was high (Rs > 0.98). Neither conventional MD nor FW-corrected MD values in the CE regions were significantly associated with overall survival. (Ps > 0.30).
conclusionA paradoxical relationship of MD values with and without FW correction was identified depending on regional characteristics and b-value settings, underscoring the importance of acquisition parameters when interpreting FW correction.
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