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IDH-mutant gliomas differ biologically from glioblastoma, as they exhibit lower tumor cellularity, longer survival, and distinct sensitivity to a variety of therapies. Whether ADC-L retains predictive utility in IDH-mutant recurrent glioma has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, single-center study, sixty patients with IDH-mutant recurrent glioma (41 astrocytoma, 19 oligodendroglioma) with measurable contrast enhancement and available pretreatment diffusion-weighted MRI who received bevacizumab were analyzed. Univariate and multivariate Cox regression and Kaplan-Meier analyses were performed for PFS and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The optimal ADC-L threshold was 1.19\u2009\u03bcm\n                      <jats:sup>2<\/jats:sup>\n                      \/ms. High ADC-L (\u22651.19\u2009\u03bcm\n                      <jats:sup>2<\/jats:sup>\n                      \/ms) was associated with significantly longer PFS (median 5.46 vs. 2.76\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) but not OS. In multivariate analysis, low ADC-L (HR\u2009=\u20092.054;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0228) and astrocytoma histology (HR\u2009=\u20092.295;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0158) were independent predictors of shorter PFS when accounting for number of prior recurrences. ADC-L was also significant predictor of PFS in both astrocytoma and oligodendroglioma patients, independently, after accounting for number of recurrences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pretreatment ADC-L predicts PFS in IDH-mutant recurrent glioma receiving bevacizumab. Supporting prospective evaluation of ADC-L as a biomarker for bevacizumab patient selection in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05782-2","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:45:06Z","timestamp":1788972306000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diffusion histogram analysis predicts progression-free survival in contrast enhancing recurrent IDH mutant gliomas treated with bevacizumab"],"prefix":"10.1007","volume":"179","author":[{"given":"Elizabeth","family":"Loxterkamp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sanvito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin T.","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina","family":"Raymond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuyin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry J.","family":"Prins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addison","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Salamon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Liau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phioanh L.","family":"Nghiemphu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Nathanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy F.","family":"Cloughesy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Ellingson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"7","key":"5782_CR1","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1001\/jama.2023.0023","volume":"329","author":"LR Schaff","year":"2023","unstructured":"Schaff LR, Mellinghoff IK (2023) Glioblastoma and other primary brain malignancies in adults: a review. 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BME serves on the Data Safety Monitoring Board for Carthera. BME has received grant funding from Siemens. BME holds stock in Katmai. TFC is cofounder, major stock holder, consultant and board member of Katmai Pharmaceuticals, member of the board for the 501c3 Global Coalition for Adaptive Research, holds stock option of Notable Labs, holds stock in Chimerix and receives milestone payments and possible future royalties, member of the scientific advisory board for Break Through Cancer, member of the scientific advisory board for Cure Brain Cancer Foundation, has provided paid consulting services to GCAR;Gan & Lee; BrainStorm; Katmai; Sapience; Inovio; Vigeo Therapeutics; DNATrix; Tyme; SDP; Novartis; Roche; Kintara; Bayer; Merck; Boehinger Ingelheim; VBL; Amgen; Kiyatec; Odonate Therapeutics QED; Medefield; Pascal Biosciences; Bayer; Tocagen; Karyopharm; GW Pharma; Abbvie; VBI; Deciphera; VBL; Agios; Genocea; Celgene; Puma; Lilly; BMS; Cortice; Wellcome Trust; Novocure; Novogen; Boston Biomedical; Sunovion; Human Longevity; Insys; ProNai; Pfizer; Notable labs; Medqia Trizel; Medscape and has contracts with UCLA for the Brain Tumor Program with Oncovir; Merck; Oncoceutics; Novartis; Amgen; Abbvie; DNAtrix; Beigene; BMS; AstraZeneca; Kazia; Agios; Boston Biomedical; Deciphera; Tocagen; Orbus; Astra Zenica; Karyopharm. DAN is a co-founder, major stockholder, consultant, and board member of Katmai Pharmaceuticals. DAN has equity in Katmai Pharmaceuticals. DAN is a co-founder of Trethera Corporation and has equity in the company. DAN has equity in Sofie Biosciences.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"75"}}