The apparent diffusion coefficient can serve as a predictor of survival in patients with gliomas.

Background and purpose: Magnetic resonance imaging is indispensable for the preoperative diagnosis of glioma. This study aimed to investigate the role of the apparent diffusion coefficient values as predictors of survival in patients with gliomas.

Methods and materials: A retrospective analysis was conducted on 101 patients with gliomas who underwent surgery between 2015 and 2020. Diffusion-weighted MRI was performed before the surgery. The regions of interest were categorized into parenchymal area, non-enhancing peritumoral area, and necrotic or cystic area. All the patients were divided into three subgroups: the parenchyma group, the non-enhancing peritumoral signal abnormality group, and the necrosis or cyst group. Univariate and multivariate analyses were performed using COX regression.

Results: In the parenchymal group, Ki67, P53, IDH, and the high or low ADC values were identified as independent prognosticators for disease-free survival, while Ki67, IDH, and the high or low ADC values for overall survival. In the non-enhancing peritumoral signal abnormality group, Ki67, P53, IDH, and the ADC _{parenchymal area}/ADC _{non-enhancing peritumoral area} ratio were identified as independent prognostic factors for disease-free survival, while Ki67, IDH, and the ADC _{parenchymal area}/ADC _{non-enhancing peritumoral area} ratio for overall survival. In the necrosis or cyst group, Ki67 was significantly associated with disease-free survival, while Ki67 and the ADC value of the necrotic or cystic area for overall survival.

Conclusions: The ADC values, including the ADC value in the parenchymal area, the ADC _{parenchymal area}/ADC _{non-enhancing peritumoral area} ratio, and the ADC value in the necrotic or cystic area, can serve as an efficient and potential index for predicting the survival of patients with glioma.