Related Experiment Video
Updated: Nov 16, 2025
Digital Spatial Profiling for Characterization of the Microenvironment in Adult-Type Diffusely Infiltrating Glioma
Published on: September 13, 2022
Role of Dynamic Susceptibility Contrast Perfusion MRI in Glioma Progression Evaluation
Guanmin Quan1, Kexin Zhang1, Yawu Liu2
1Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Abstract:
Accurately and quickly differentiating true progression from pseudoprogression in glioma patients is still a challenge. This study aims to explore if dynamic susceptibility contrast- (DSC-) MRI can improve the evaluation of glioma progression. We enrolled 65 glioma patients with suspected gadolinium-enhancing lesion. Longitudinal MRI follow-up (mean 590 days, range: 210-2670 days) or re-operation (n = 3) was used to confirm true progression (n = 51) and pseudoprogression (n = 14). We assessed the diagnostic performance of each MRI variable and the different combinations. Our results showed that the relative cerebral blood volume (rCBV) in the true progression group (1.094, 95%CI: 1.135-1.636) was significantly higher than that of the pseudoprogression group (0.541 ± 0.154) (p < 0.001). Among the 18 patients who had serial DSC-MRI, the rCBV of the progression group (0.480, 95%CI: 0.173-0.810) differed significantly from pseudoprogression (-0.083, 95%CI: -1.138-0.620) group (p=0.015). With an rCBV threshold of 0.743, the sensitivity and specificity for discriminating true progression from pseudoprogression were 76.5% and 92.9%, respectively. The Cho/Cr and Cho/NAA ratios of the true progression group (2.520, 95%CI: 2.331-2.773; 2.414 ± 0.665, respectively) were higher than those of the pseudoprogression group (1.719 ± 0.664; 1.499 ± 0.500, respectively) ((p=0.001), (p < 0.001), respectively). The areas under ROC curve (AUCs) of enhancement pattern, MRS, and DSC-MRI for the differentiation were 0.782, 0.881, and 0.912, respectively. Interestingly, when combined enhancement pattern, MRS, and DSC-MRI variables, the AUC was 0.965 and achieved sensitivity 90.2% and specificity 100.0%. Our results suggest that DSC-MRI can significantly improve the diagnostic performance for identifying glioma progression. DSC-MRI combined with conventional MRI may promptly distinguish true gliomas progression from pseudoprogression when the suspected gadolinium-enhancing lesion was found, without the need for a long-term follow-up.
Insights
Dynamic susceptibility contrast (DSC)-MRI significantly improves the differentiation of true glioma progression from pseudoprogression. This advanced imaging technique, when combined with conventional MRI, offers a faster and more accurate diagnosis without lengthy follow-up.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Distinguishing true progression from pseudoprogression in glioma patients presents a significant clinical challenge.
- Accurate and timely diagnosis is crucial for effective treatment planning and patient management.
- Conventional MRI methods may not always provide sufficient clarity in these differentiating cases.
Purpose of the Study:
- To evaluate the efficacy of dynamic susceptibility contrast (DSC)-MRI in improving the assessment of glioma progression.
- To compare the diagnostic performance of DSC-MRI with conventional MRI techniques and Magnetic Resonance Spectroscopy (MRS).
- To determine the combined diagnostic utility of DSC-MRI, MRS, and enhancement patterns.
Main Methods:
- Sixty-five glioma patients with suspected gadolinium-enhancing lesions were enrolled.
- True progression and pseudoprogression were confirmed through longitudinal MRI follow-up or re-operation.
- Diagnostic performance was assessed using relative cerebral blood volume (rCBV) from DSC-MRI, MRS ratios (Cho/Cr, Cho/NAA), and enhancement patterns.
Main Results:
- Relative cerebral blood volume (rCBV) was significantly higher in the true progression group compared to the pseudoprogression group (p < 0.001).
- The combination of enhancement pattern, MRS, and DSC-MRI achieved an Area Under the Curve (AUC) of 0.965, with 90.2% sensitivity and 100.0% specificity.
- DSC-MRI alone demonstrated an AUC of 0.912, outperforming MRS (AUC=0.881) and enhancement patterns (AUC=0.782).
Conclusions:
- Dynamic susceptibility contrast (DSC)-MRI significantly enhances the diagnostic performance in differentiating true glioma progression from pseudoprogression.
- Combining DSC-MRI with conventional MRI and MRS provides a robust and prompt method for diagnosis, potentially obviating the need for prolonged follow-up.
- This integrated imaging approach facilitates timely clinical decision-making for glioma patients.
More Related Videos
Related Concept Videos
01:24Magnetic Resonance Imaging
01:17Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...