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Low-grade (WHO II) and anaplastic (WHO III) gliomas: differences in morphology and MRI signal intensities
Max-Ludwig Schäfer1, Martin H Maurer, Michael Synowitz
1Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany, max-ludwig.schaefer@charite.de.
Objective:
To evaluate the diagnostic potential of a multi-factor analysis of morphometric parameters and signal characteristics of brain tumours and peritumoural areas for distinguishing WHO-grade II and III gliomas at magnetic resonance imaging (MRI).
Methods:
MR examinations of 108 patients with histologically proven World Health Organization (WHO) grade II and III gliomas were included. Morphological criteria and MR signal characteristics were evaluated. The data were subjected to a multifactorial logistic regression analysis to differentiate between grade II and grade III gliomas. The discriminatory power was assessed by receiver operating characteristic (ROC).
Results:
Logistic regression analysis showed that WHO grade II and III can be distinguished based on contrast enhancement, cortical involvement, margin of the enhancing lesion and maximum diameter (width and length) of the peritumoural area (the so-called tumour infiltration zone). With the final model of logistic regression analysis and with the cut-off value ≥ 0.377, WHO grade III glioma is predicted with a sensitivity of 71.0 % and a specificity of 80.4 %.
Conclusion:
Measurement of maximum diameter of peritumoural area, contrast enhancement as well as cortical involvement and the margin of the contrast-enhancing lesion can be used easily in clinical routine to adequately distinguish WHO grade II from grade III gliomas.
Key Points:
• MRI offers new information concerning WHO-grade II and III gliomas. • The differentiation between such tumour grades is important for therapeutic decisions. • We assessed differences in enhancement, cortical involvement, margins and peritumoural appearances. • WHO grade III gliomas can be predicted with reasonable sensitivity and specificity.
Insights
Magnetic resonance imaging (MRI) can differentiate between World Health Organization (WHO) grade II and III gliomas using specific features. This analysis aids in distinguishing tumor grades for better treatment decisions.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Accurate grading of gliomas is crucial for treatment planning.
- Distinguishing between World Health Organization (WHO) grade II and III gliomas can be challenging with conventional MRI.
- Magnetic resonance imaging (MRI) offers potential for improved diagnostic accuracy.
Purpose of the Study:
- To assess the diagnostic capability of multi-factor analysis of MRI morphometric and signal characteristics.
- To differentiate between WHO grade II and III gliomas using brain tumor and peritumoral area features.
- To evaluate the potential of MRI in distinguishing glioma grades for clinical application.
Main Methods:
- Retrospective analysis of MR examinations from 108 patients with WHO grade II and III gliomas.
- Evaluation of morphological criteria and MR signal characteristics.
- Multifactorial logistic regression analysis and receiver operating characteristic (ROC) curves for discriminatory power assessment.
Main Results:
- Logistic regression identified contrast enhancement, cortical involvement, lesion margin, and maximum peritumoral area diameter as key differentiating factors.
- The final model achieved a sensitivity of 71.0% and a specificity of 80.4% for predicting WHO grade III gliomas (cut-off ≥ 0.377).
- These parameters effectively distinguish between WHO grade II and III gliomas.
Conclusions:
- Maximum peritumoral area diameter, contrast enhancement, cortical involvement, and lesion margin are easily measurable in clinical practice.
- These MRI features provide valuable information for distinguishing WHO grade II from grade III gliomas.
- The findings support the use of these MRI parameters to guide therapeutic decisions.
