Magnetic resonance diffusion metrics indexing high focal cellularity and sharp transition at the XXXX boundary predict poor outcome in @entity463 .

@entity1 @entity146 @entity5 @entity4 @entity1054 @entity1893 @entity463 @entity1349
AIM: To investigate the prognostic power of intra-tumoural and gradient magnetic resonance imaging (MRI) diffusion metrics in @entity1 with @entity463 ( @entity463 ). MATERIALS AND METHODS: Forty-six consecutive @entity1 with histologically confirmed @entity463 who had undergone preoperative diffusion tensor imaging at 3  T were included. @entity1893 ( @entity1893 ) and @entity1893 gradient maps were computed. Regions of interest were analysed to determine the minimum @entity1893 within the enhancing @entity5 (minMD). @entity1893 gradients were calculated along the enhancing @entity5 boundary and subjected to histogram analysis. @entity1349 ( @entity1349 ) and @entity1054 ( @entity1054 ) were derived and survival analysis was undertaken. RESULTS: There were 31 deaths and 37 @entity1 progressed during the study period. Multivariate survival analysis, controlling for treatment and gender, showed that minMD values<6.1*10(-4)  mm(2)/s predicted shorter @entity1349 (hazard ratio [HR]=2.82, 1.25-6.34; p=0.012) and @entity1054 (HR=5.43, 1.96-15.05; p=0.001). Higher @entity1893 gradient values of the @entity5 boundary predicted shorter survival: @entity1893 gradient values >4.7*10(-5)  mm(2)/s (10(th) centile) had a significantly shorter @entity1349 with a HR of 0.43 (0.19-0.96; p=0.04). Similarly, a value above 1.4*10(-4) mm(2)/s (75(th) centile) was a significant predictor for shorter @entity1349 (HR=0.39, 0.17-0.89; p=0.03). CONCLUSIONS: Lower minMD and higher @entity1893 gradient values for the 10(th) and 75(th) percentile of the @entity5 boundary demonstrated prognostic value in preoperative @entity463 . This suggests that MRI diffusion metrics indicative of higher focal cellularity and steeper transition from high cellular @entity5 edge to low cellular @entity4 define @entity146 subtypes with a poorer prognosis.
