UNASSIGNED: We analyzed whether the combined visualization of decreased apparent diffusion coefficient (ADC) values and increased cerebral blood volume (CBV) in perfusion imaging can identify prognosis-related growth patterns in @entity1 with newly diagnosed @entity463 . Sixty-five consecutive @entity1 were examined with diffusion and dynamic susceptibility-weighted contrast-enhanced perfusion weighted MRI. ADC and CBV maps were co-registered on the T1-w image and a region of interest (ROI) was manually delineated encompassing the enhancing lesion. Within this ROI pixels with ADC values <the 30th percentile (ADCmin), pixels with CBV values >the 70th percentile (CBVmax) and the intersection of pixels with ADCmin and CBVmax were automatically calculated and visualized. Initially, all @entity5 with a mean intersection greater than the upper quartile of the normally distributed mean intersection of all @entity1 were subsumed to the first growth pattern termed big intersection (BI). Subsequently, the remaining @entity5 ' growth patterns were categorized depending on the qualitative representation of ADCmin, CBVmax and their intersection. Log-rank test exposed a significantly longer overall survival of BI (n  =  16) compared to non-BI group (n  =  49) (p  =  0.0057). Thirty-one, four and 14 @entity1 of the non-BI group were classified as predominant ADC-, CBV- and mixed growth group, respectively. In a multivariate Cox regression model, the BI-, CBV- and mixed groups had significantly lower adjusted hazard ratios (p-value, aBonferroni  <  0.006) when compared to the reference group ADC: 0.29 (0.0027), 0.11 (0.038) and 0.33 (0.0059). Our study provides evidence that the combination of diffusion and perfusion imaging allows visualization of different @entity463 growth patterns that are associated with prognosis. A possible biological hypothesis for this finding could be the interpretation of the ADCmin fraction as the invasion-front of @entity5 cells while the CBVmax fraction might represent the vascular rich @entity5 border that is "trailing behind" the invasion-front in the ADC group.

Prognostic value of combined visualization of MR diffusion and perfusion maps in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity463 :: ('MESH:D005909', 'Disease') :: ['glioblastoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors']
@entity463 :: (MESH:D005909,Disease) :: ['glioblastoma']
