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Prospective glioma grading using single-dose dynamic contrast-enhanced perfusion MRI
1Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India.
Aim:
To evaluate the sensitivity and specificity of single-dose dynamic contrast-enhanced (DCE) perfusion magnetic resonance imaging (MRI) in prospective evaluation of glioma grading and to correlate the relative cerebral blood volume (rCBV) values with mitotic and ki-67 indexes obtained at histopathology.
Materials And Methods:
A total of 53 histologically proven patients with glioma were included in this study. DCE-MRI perfusion with a single dose of contrast medium was included in brain tumour protocol and prospective grading of glioma into low and high grade was done based on a previously reported rCBV cut-off value of 3. Tumours with rCBV ≥ 3 were considered to be high grade and rCBV < 3 were considered to be low grade. The sensitivity and specificity of the cut-off value were estimated. Ki-67 and mitotic indexes were also obtained on histopathological analysis along with histological grading.
Results:
Based on pre-defined rCBV cut-off values, prospective grading of low- and high-grade glioma was achieved with a sensitivity and specificity of 97.22% and 100%, respectively. Significant correlation was found between the mitotic/ki-67 indexes and rCBV values when data for high- and low-grade tumours was combined.
Conclusion:
DCE-MRI performed with a single dose of contrast medium is as effective as a protocol with a double-dose of contrast medium for glioma grading using 3 T MRI and could be added to the routine evaluation protocol of brain tumours.
Insights
Single-dose dynamic contrast-enhanced MRI effectively grades gliomas with high sensitivity and specificity. This method correlates well with histopathology, offering a reliable tool for brain tumor evaluation.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Glioma grading is crucial for treatment planning and prognosis.
- Accurate grading often relies on histopathology, which can be invasive.
- Dynamic contrast-enhanced (DCE) perfusion MRI offers a non-invasive method for assessing tumor characteristics.
Purpose of the Study:
- To assess the sensitivity and specificity of single-dose DCE perfusion MRI for glioma grading.
- To correlate relative cerebral blood volume (rCBV) values with histopathological markers (mitotic and Ki-67 indexes).
- To evaluate the efficacy of a single-dose contrast protocol for glioma grading.
Main Methods:
- 53 patients with histologically confirmed gliomas underwent single-dose DCE-perfusion MRI.
- Gliomas were prospectively graded into low and high grade using an rCBV cutoff value of 3.
- Sensitivity, specificity, mitotic index, and Ki-67 index were calculated.
Main Results:
- Single-dose DCE-MRI demonstrated high sensitivity (97.22%) and specificity (100%) for glioma grading.
- A significant correlation was observed between rCBV values and mitotic/Ki-67 indexes when combining low- and high-grade tumors.
- The single-dose protocol proved effective for differentiating glioma grades.
Conclusions:
- Single-dose DCE-perfusion MRI is a highly sensitive and specific tool for glioma grading.
- This method is as effective as double-dose protocols and can be integrated into routine brain tumor imaging protocols.
- DCE-MRI provides valuable non-invasive data for glioma evaluation.
