Value of whole-lesion histogram analysis based on ADC and ASL in predicting the response to chemotherapy and prognosis of PCNSL

Motivation: Primary central nervous system lymphoma (PCNSL) is a rare malignant non-Hodgkin's lymphoma with a poor prognosis, the combination chemotherapy regimen based on methotrexate is the main therapeutic regimen. There are no reliable indicators to predict the treatment response and survival outcome of PCNSL patients. Goal(s): To predict the response to methotrexate (MTX) chemotherapy and prognosis in primary central nervous system lymphoma (PCNSL) patients by the histogram parameters based on apparent diffusion coefficient (ADC) and arterial spin labeling (ASL). Approach: Use the univariate and multivariate logistic regressions to identify the independent predictors for the response of MTX chemotherapy. The predictive performance was assessed by the receiver operating characteristic. The Kaplan-Meier analysis and Cox regression were used to analyze the OS. Results: Number of lesions (NL), the maximum of ADC values and the 95th percentile of CBF values were independent predictive factors of chemotherapy response. Impact: ADC and CBF values are promising predictive factors of chemotherapy response and outcome in PCNSL patients.