AUTHOR=Zeng Qiang , Jiang Biao , Shi Feina , Ling Chenhan , Dong Fei , Zhang Jianmin 

TITLE=Bright Edge Sign on High b-Value Diffusion-Weighted Imaging as a New Imaging Biomarker to Predict Poor Prognosis in Glioma Patients: A Retrospective Pilot Study

JOURNAL=Frontiers in Oncology

VOLUME=9

YEAR=2019

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2019.00424

DOI=10.3389/fonc.2019.00424

ISSN=2234-943X

ABSTRACT=<p><bold>Purpose:</bold> To investigate the prognostic value of bright edge sign observed on high b-value diffusion-weighted imaging (DWI) map in glioma patients.</p><p><bold>Methods:</bold> We retrospectively reviewed our prospectively collected database for gliomas. Bright edge sign was defined as the presence of extremely high signal in tumor margin on high b-value DWI map (<italic>b</italic> = 3,000 s/mm<sup>2</sup>) with the signal intensity higher than those in contralateral normal white matter and tumor central region. Extremely poor prognosis was defined as overall survival time &lt; 9 months. Survival analyses were conducted by using the Cox regression for both the univariable and multivariable analyses.</p><p><bold>Results:</bold> A total of 52 patients were enrolled (WHO IV, 25; WHO III, 13; WHO II, 14). Bright edge sign presented in 10 (19.2%) patients (WHO IV, 5; WHO III, 3; WHO II, 2). Nine (90.0%) patients with bright edge sign had extremely poor prognosis, while only 1 (2.4 %) patient without bright edge sign had extremely poor prognosis. The sensitivity and specificity of bright edge sign in determining extremely poor prognosis were 90 and 97.7%, respectively. Bright edge sign (HR [95% CI] = 25.11 [7.26–86.81], <italic>p</italic> &lt; 0.001) was an independent predictor of poor prognosis after adjustment.</p><p><bold>Conclusion:</bold> Bright edge sign on high b-value DWI may be an accurate predictor of extremely poor prognosis in glioma patients, regardless of pathologic grades.</p>