Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery. Mexico City, Mexico. Av. Insurgentes Sur 3877. CP 14269. Mexico City, Mexico.
Background: Histological behavior of glioblastoma multiforme (GBM) suggests it would benefit more from a global rather than regional evaluation. A global (whole-brain) calculation of DTI-derived tensor metrics offers a valid method to detect the integrity of white matter structures without missing infiltrated brain areas not seen in conventional sequences. The aim of this study was to perform an integrative evaluation of tensor metrics in patients with GBM.
Methods: Retrospective, case and control study; 11 global DTI-derived tensor metrics were calculated in 27 patients with GBM and 34 controls: MD, FA, p, q, L, Cl, Cs, Cp, RA, Rd and AD. Multivariate discriminant analysis of these variables (including age) with diagnostic test evaluation was performed.
Results: The simultaneous analysis of 732 measures from 12 continuous variables in 61 subjects revealed one discriminant model that significantly differentiated normal brains and brains with GBM: Wilks’ l = 0.324, c2 (3) = 38.907, p < .001. The overall predictive accuracy was 92.7%.Conclusions: We present a phase II study introducing a novel global approach using biomarkers of brain impairment. The final predictive model selected only three metrics: AD, Cs and Cl. These metrics might be clinically applied for diagnosis, follow-up, and the study of other neurological diseases.