Multi-modal magnetic resonance imaging in efficacy assessment of combined therapy for glioma

Objective: To study the application of multi-modal magnetic resonance imaging (MRI) in efficacy assessment of therapy for glioma. Methods: We enrolled 108 patients with glioma confirmed by biopsy in this retrospective study. They were randomized into the observation group (n = 54) and the control group (n = 54). Multi-modal MRI was used in the observation group and CT scan was used in the control group to detect the normal and cancer tissues in brain for apparent diffusion coefficient (ADC), early-phase enhancement rate, and the type of dynamic contrast enhanced time intensity curve (TIC) shape. The detections were performed again after surgical resection of glioma and chemoradiotherapy. The rate of complete resection after the first surgery and the differences in the ADC before and after chemoradiotherapy were compared between the two groups. The early-phase enhancement rate and the type of TIC shape of the cancer tissue before and after chemoradiotherapy were compared with those of the normal tissue. The association between patients' survival rates and the results of multi-modal MRI were also analyzed. Results: The difference in the ADC before and after chemoradiotherapy was statistically significant in both groups (both P < 0.05). The rate of complete resection after the first surgery was significantly lower in the observation group than in the control group (P < 0.05). There were statistical differences betwen the early-phase enhancement rates of the normal tissues and those of the cancer tissues before and after chemoradiotherapy (all P < 0.001). The type of TIC shape of the normal tissue was persistent enhancement, while that of the tumor tissue was mostly high enhancement with plateau before chemoradiotherapy and was persistent enhancement in 79.63% of cases after chemoradiotherapy. The difference in the type of TIC shape was statistically significant (P < 0.001). In the observation group, the one-year survival rate was 90.74%, the three-year survival rate was 79.63%, and the five-year survival rate was 66.67%, all significantly higher than those of the control group (all P < 0.001). Conclusion: Multi-modal MRI provides accurate information about the ADC and early-phase enhancement rate of the tissues, the rate of complete resection of cancer tissues, and semi-quantitative analysis by TIC. Moreover, it compares the tissues before and after chemoradiotherapy to determine the effectiveness of the treatment, and then provides reference for planning of subsequent treatment.