Differentiating the histologic grades of gliomas preoperatively using amide proton transfer-weighted (APTW) and
Tianyu Zou1, Hao Yu1, Chunxiu Jiang1
1Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Abstract:
The purpose of this work was to investigate the diagnostic performance of amide proton transfer-weighted (APTW) and intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the preoperative grading of gliomas. Fifty-one patients with suspected gliomas were recruited and underwent a preoperative MRI examination that included APTW and IVIM sequences. All cases were confirmed by postsurgical histopathology. APTW signal intensity, true diffusion coefficient (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) were applied to assess the solid tumor component and contralateral normal-appearing white matter. The relative APTW signal intensity (rAPTW) was also used. Independent-sample and paired-sample t-tests were used to compare differences in MRI parameters between low-grade glioma (LGG) and high-grade glioma (HGG) groups. The diagnostic performance was assessed with the receiver operating characteristic curve. Twenty-six patients were pathologically diagnosed with LGG and 25 were diagnosed with HGG. APTW, rAPTW and f values were significantly higher (all p < 0.001), whereas D values were significantly lower (p < 0.001) in the HGG group than in the LGG group. There was no significant difference between D* values for the two groups. rAPTW had an area under the curve (AUC) of 0.957, with a sensitivity of 100% and a specificity of 84.6%, followed by APTW, f, D and D*. The combined use of APTW and IVIM showed the best diagnostic performance, with an AUC of 0.986. In conclusion, APTW and IVIM, as two promising supplementary sequences for routine MRI, could be valuable in differentiating LGGs from HGGs.
Insights
Amide proton transfer-weighted (APTW) and intravoxel incoherent motion (IVIM) MRI show promise for preoperative glioma grading. These techniques effectively differentiate low-grade gliomas (LGG) from high-grade gliomas (HGG), improving diagnostic accuracy.
Area of Science:
- Radiology and Imaging
- Neuro-oncology
- Medical Physics
Background:
- Accurate preoperative grading of gliomas is crucial for treatment planning and patient management.
- Distinguishing between low-grade glioma (LGG) and high-grade glioma (HGG) preoperatively remains a challenge with conventional MRI.
- Advanced MRI techniques like APTW and IVIM offer potential for improved tissue characterization.
Purpose of the Study:
- To evaluate the diagnostic performance of amide proton transfer-weighted (APTW) and intravoxel incoherent motion (IVIM) MRI in the preoperative grading of gliomas.
- To assess the ability of APTW and IVIM parameters to differentiate between LGG and HGG.
Main Methods:
- Fifty-one patients with suspected gliomas underwent preoperative MRI including APTW and IVIM sequences.
- Key MRI parameters analyzed included APTW signal intensity, relative APTW (rAPTW), true diffusion coefficient (D), perfusion fraction (f), and pseudo-diffusion coefficient (D*).
- Statistical analysis, including t-tests and receiver operating characteristic (ROC) curve analysis, was used to compare parameters between LGG and HGG groups.
Main Results:
- Higher APTW, rAPTW, and f values, and lower D values were significantly associated with HGG compared to LGG (p < 0.001).
- No significant difference in D* values was observed between the groups.
- rAPTW achieved an area under the curve (AUC) of 0.957. The combined use of APTW and IVIM yielded the highest diagnostic performance with an AUC of 0.986.
Conclusions:
- APTW and IVIM MRI sequences are valuable tools for differentiating between LGG and HGG.
- These advanced MRI techniques can serve as effective supplementary tools to routine MRI for preoperative glioma grading.
- The combined application of APTW and IVIM demonstrates superior diagnostic performance in glioma grading.
