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A Novel High-resolution In vivo Imaging Technique to Study the Dynamic Response of Intracranial Structures to Tumor Growth and Therapeutics
Published on: June 16, 2013
Intravoxel Incoherent Motion MR Imaging of Pediatric Intracranial Tumors: Correlation with Histology and Diagnostic
K Kikuchi1, A Hiwatashi2, O Togao1
1From the Departments of Clinical Radiology (K.K., A.H., O.T., K.Y., R.K., D.M., H.H.).
Background And Purpose:
Intravoxel incoherent motion imaging, which simultaneously measures diffusion and perfusion parameters, is promising for brain tumor grading. However, intravoxel incoherent motion imaging has not been tested in children. The purpose of this study was to evaluate the correlation between intravoxel incoherent motion parameters and histology to assess the accuracy of intravoxel incoherent motion imaging for pediatric intracranial tumor grading.
Materials And Methods:
Between April 2013 and September 2015, 17 children (11 boys, 6 girls; 2 months to 15 years of age) with intracranial tumors were included in this retrospective study. Intravoxel incoherent motion parameters were fitted using 13 b-values for a biexponential model. The perfusion-free diffusion coefficient, pseudodiffusion coefficient, and perfusion fraction were measured in high- and low-grade tumors. These intravoxel incoherent motion parameters and the ADC were compared using the unpaired t test. The correlations between the intravoxel incoherent motion parameters and microvessel density or the MIB-1 index were analyzed using the Spearman correlation test. Receiver operating characteristic analysis was used to evaluate diagnostic performance.
Results:
The perfusion-free diffusion coefficient and ADC were lower in high-grade than in low-grade tumors (perfusion-free diffusion coefficient, 0.85 ± 0.40 versus 1.53 ± 0.21 × 10-3 mm2/s, P < .001; ADC, 1.04 ± 0.33 versus 1.60 ± 0.21 × 10-3 mm2/s, P < .001). The pseudodiffusion coefficient showed no difference between the groups. The perfusion fraction was higher in high-grade than in low-grade tumors (21.7 ± 8.2% versus 7.6 ± 4.3%, P < .001). Receiver operating characteristic analysis found that the combined perfusion-free diffusion coefficient and perfusion fraction had the best diagnostic performance for tumor differentiation (area under the curve = 0.986).
Conclusions:
Intravoxel incoherent motion imaging reflects tumor histology and may be a helpful, noninvasive method for pediatric intracranial tumor grading.
Insights
Intravoxel incoherent motion imaging shows promise for grading pediatric brain tumors. This study found specific parameters correlate with tumor grade, offering a noninvasive diagnostic tool.
Area of Science:
- Radiology
- Pediatric Oncology
- Medical Imaging
Background:
- Intravoxel incoherent motion (IVIM) imaging measures diffusion and perfusion, showing potential for brain tumor grading.
- IVIM imaging has not been previously evaluated in pediatric populations.
- Pediatric intracranial tumors require accurate grading for appropriate treatment.
Purpose of the Study:
- To evaluate the accuracy of IVIM imaging for grading pediatric intracranial tumors.
- To assess the correlation between IVIM parameters and tumor histology.
- To determine if IVIM can differentiate between high- and low-grade pediatric brain tumors.
Main Methods:
- Retrospective study of 17 children with intracranial tumors (age range: 2 months to 15 years).
- IVIM parameters (perfusion-free diffusion coefficient, pseudodiffusion coefficient, perfusion fraction) were measured using a biexponential model with 13 b-values.
- Statistical analysis included unpaired t-tests, Spearman correlation, and receiver operating characteristic (ROC) analysis.
Main Results:
- Perfusion-free diffusion coefficient and ADC were significantly lower in high-grade tumors compared to low-grade tumors (P < .001).
- Perfusion fraction was significantly higher in high-grade tumors than in low-grade tumors (P < .001).
- Combined perfusion-free diffusion coefficient and perfusion fraction achieved the highest diagnostic performance for tumor differentiation (AUC = 0.986).
Conclusions:
- IVIM imaging parameters correlate with the histological grade of pediatric intracranial tumors.
- IVIM imaging may serve as a valuable, noninvasive tool for grading pediatric brain tumors.
- Further validation of IVIM in larger pediatric cohorts is warranted.
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