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Discrimination between glioma grades II and III in suspected low-grade gliomas using dynamic contrast-enhanced and
Anna Falk1, Markus Fahlström, Egill Rostrup
1Department of Radiology, Oncology and Radiation Science, Section of Radiology, Uppsala University, BFC Akademiska sjukhuset, SE 751 85, Uppsala, Sweden, aka03nfa@gmail.com.
Introduction:
Perfusion magnetic resonance imaging (MRI) can be used in the pre-operative assessment of brain tumours. The aim of this prospective study was to identify the perfusion parameters from dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) perfusion imaging that could best discriminate between grade II and III gliomas.
Methods:
MRI (3 T) including morphological ((T2 fluid attenuated inversion recovery (FLAIR) and T1-weighted (T1W)+Gd)) and perfusion (DCE and DSC) sequences was performed in 39 patients with newly diagnosed suspected low-grade glioma after written informed consent in this review board-approved study. Regions of interests (ROIs) in tumour area were delineated on FLAIR images co-registered to DCE and DSC, respectively, in 25 patients with histopathological grade II (n = 18) and III (n = 7) gliomas. Statistical analysis of differences between grade II and grade III gliomas in histogram perfusion parameters was performed, and the areas under the curves (AUC) from the ROC analyses were evaluated.
Results:
In DCE, the skewness of transfer constant (k(trans)) was found superior for differentiating grade II from grade III in all gliomas (AUC 0.76). In DSC, the standard deviation of relative cerebral blood flow (rCBF) was found superior for differentiating grade II from grade III gliomas (AUC 0.80).
Conclusions:
Histogram parameters from k(trans) (DCE) and rCBF (DSC) could most efficiently discriminate between grade II and grade III gliomas.
Insights
Perfusion MRI parameters, specifically skewness of transfer constant (ktrans) from DCE and standard deviation of relative cerebral blood flow (rCBF) from DSC, effectively differentiate grade II and III gliomas.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Perfusion magnetic resonance imaging (MRI) is a valuable tool for pre-operative assessment of brain tumors.
- Differentiating glioma grades is crucial for treatment planning and prognosis.
Purpose of the Study:
- To identify specific perfusion parameters from dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) MRI that best distinguish between grade II and III gliomas.
Main Methods:
- Prospective study involving 39 patients with newly diagnosed suspected low-grade gliomas.
- MRI (3 T) included morphological (T2 FLAIR, T1W+Gd) and perfusion (DCE, DSC) sequences.
- Histogram analysis of perfusion parameters (ktrans, rCBF) was performed on regions of interest in 25 patients with confirmed grade II (n=18) and grade III (n=7) gliomas.
Main Results:
- Skewness of transfer constant (ktrans) in DCE imaging showed high discriminatory power (AUC 0.76).
- Standard deviation of relative cerebral blood flow (rCBF) in DSC imaging demonstrated superior differentiation (AUC 0.80).
Conclusions:
- Histogram parameters derived from ktrans (DCE) and rCBF (DSC) are efficient in discriminating between grade II and grade III gliomas.
- These perfusion parameters can aid in pre-operative grading of gliomas.
