Isolated Diffusion Restriction Preceding Contrast Enhancement in Glioblastoma Multiforme is Associated with Short-Term Survival
Bibliographic record
Abstract
(1) Background: Current imaging standard for detecting and assessing glioblastoma multiforme (GBM) progression depends on contrast-enhancement on brain magnetic resonance imaging (MRI). Isolated foci of diffusion restriction have been observed to precede enhancement in GBM. The aim of our study was to investigate the frequency of isolated diffusion restriction that precede corresponding enhancement and to investigate the association between isolated diffusion restriction and survival in patients with GBM. (2) Methods: MRI of the brain, including diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) maps were retrospectively examined in 102 consecutively treated patients with histopathologically confirmed GBM. Images were assessed for the presence of isolated diffusion restriction in GBM and identified lesions were monitored for enhancement on follow-up MRI. Data were collected on the length of time for enhancement to appear, normalized ADC, and overall survival of patients. (3) Results: Forty patients (39.2%) showed areas of isolated diffusion restriction. Ten patients (25%) developed corresponding enhancement on follow-up imaging after an average of 145 days after the index imaging. In patients with isolated restricted diffusion, the mean ADC was 721.4 ± 117.2 mm2/s compared to 888.7 ± 85.2 mm2/s in the normal appearing-white matter (NAWM) in contralateral hemisphere (p<0.001). On survival analysis, the overall survival was longer (p=0.036) in patients with isolated restricted diffusion and these patients had survival benefit (p=0.006) in the early follow-up period. (4) Conclusions: Isolated restricted diffusion in GBM precedes corresponding enhancement in a subset of patients with GBM and was associated with early survival benefit.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".