Multiparametric study for glioma grading with FLAIR, ADC map, eADC map, T1 map, and SWI images

This paper is a preliminary attempt to compare the diagnostic efficiency and performance of Fluid-attenuated inversion recovery (FLAIR), apparent diffusion coefficient (ADC) map, exponential ADC (eADC) map, T₁ map, and Susceptibility-weighted image (SWI) for glioma grading and combine these image data pairs to compare the diagnostic performance of different image data pairs for glioma grading.

Fifty-nine patients underwent FLAIR, ADC map, eADC map, Variable flip-angle (VFA) spoiled gradient recalled echo (SPGR) method, and SWI MRI imaging. The T₁ map was reconstructed by the VFA-SPGR method. The average Relative Signal Contrast (RSC) and receiver operating characteristic curve (ROC) was calculated in a different image. The multivariate binary logistic regression model combined different image data pairs.

The average RSC of SWI and ADC maps in high-grade glioma is significantly lower than RSCs in low-grade. The average RSC of the eADC map and T₁ maps increased with glioma grade. No significant difference was detected between low and high-grade glioma on FLAIR images. The AUC for low and high-grade glioma differentiation on ADC maps, eADC maps, T₁ map, and SWI were calculated 0.781, 0.864, 0.942, and 0.904, respectively. Also, by adding different image data, diagnostic performance was increased.

Interestingly, the T₁ map and SWI image have the potential to use in the clinic for glioma grading purposes due to their high performance. Also, the eADC map+T₁ map and T₁ map+SWI image weights have the highest diagnostic performance for glioma grading.