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Updated: Jul 28, 2025
Automated Segmentation of Cortical Grey Matter from T1-Weighted MRI Images
Published on: January 7, 2019
Glioma grading using multiparametric MRI: head-to-head comparison among dynamic susceptibility contrast, dynamic
Minkook Seo1, Yangsean Choi2, Youn Soo Lee3
1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Purpose:
To assess the diagnostic accuracy of dynamic susceptibility contrast, dynamic contrast-enhancement, MR spectroscopy (MRS), and diffusion-weighted imaging for differentiating high-grade (HGGs) from low-grade gliomas (LGGs).
Methods:
Seventy-two patients (16 LGGs, 56 HGGs) with pathologically confirmed gliomas were retrospectively included. From three-dimensionally segmented tumor, histogram analyses of relative cerebral blood volume (rCBV), volume transfer constant (Ktrans), and apparent diffusion coefficient (ADC) were performed. Choline-to-creatinine ratio (Cho/Cr) was calculated using MRS. Logistic regression analyses were performed to differentiate HGGs (grade ≥ 3) from LGGs (grade ≤ 2). Areas under the receiver operating characteristics curves (AUC) were plotted. Subgroup analysis was performed between IDH-wildtype glioblastomas and IDH-mutant astrocytomas. Pairwise Spearman's correlation coefficients (ρ) were computed.
Results:
HGGs had higher 95th percentile rCBV, Ktrans and Cho/Cr (P < 0.01) than LGGs. AUC of 95th percentiles of rCBV and Ktrans were 0.79 (95% CI, 0.67-0.91) and 0.74 (95% CI, 0.59-0.88), respectively. AUC of 5th percentile of ADC was 0.63 (95% CI, 0.48-0.79), and that of Cho/Cr was 0.67 (95% CI, 0.52-0.81). IDH-wildtype glioblastomas and IDH-mutant astrocytomas showed significantly different 95th percentile rCBV (P = 0.04) and Ktrans (P < 0.01), with Ktrans showing the highest AUC (0.73, 95% CI 0.57-0.89) in IDH status prediction. Moderate correlations were observed between 95th percentile rCBV and Ktrans (ρ = 0.47), Cho/Cr (ρ = 0.40), and 5th percentile ADC (ρ = -0.36) (all P < 0.01).
Conclusions:
The 95th percentile rCBV may be most helpful in discriminating HGGs from LGGs. The 95th percentile Ktrans may aid predicting IDH status of diffuse gliomas.
Insights
Dynamic susceptibility contrast (DSC) and dynamic contrast-enhancement (DCE) MRI, MR spectroscopy (MRS), and diffusion-weighted imaging (DWI) can help differentiate high-grade gliomas (HGGs) from low-grade gliomas (LGGs). The 95th percentile of relative cerebral blood volume (rCBV) is most effective for this distinction.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Accurate differentiation between high-grade gliomas (HGGs) and low-grade gliomas (LGGs) is crucial for appropriate patient management and treatment planning.
- Advanced MRI techniques offer potential for non-invasive assessment of glioma biology and grade.
- Identifying specific imaging biomarkers can improve diagnostic accuracy and guide therapeutic strategies.
Purpose of the Study:
- To evaluate the diagnostic performance of dynamic susceptibility contrast (DSC), dynamic contrast-enhancement (DCE), MR spectroscopy (MRS), and diffusion-weighted imaging (DWI) in distinguishing HGGs from LGGs.
- To assess the utility of these advanced MRI techniques in predicting IDH mutation status in diffuse gliomas.
Main Methods:
- Retrospective analysis of 72 patients with pathologically confirmed gliomas (16 LGGs, 56 HGGs).
- Histogram analysis of relative cerebral blood volume (rCBV), volume transfer constant (Ktrans), and apparent diffusion coefficient (ADC) from segmented tumors.
- Calculation of choline-to-creatinine ratio (Cho/Cr) using MRS; logistic regression and ROC curve analysis for diagnostic accuracy; subgroup analysis for IDH status.
Main Results:
- HGGs demonstrated significantly higher 95th percentile rCBV, Ktrans, and Cho/Cr compared to LGGs (P < 0.01).
- Areas under the ROC curves (AUC) for differentiating HGGs from LGGs were 0.79 for 95th percentile rCBV and 0.74 for 95th percentile Ktrans.
- IDH-wildtype glioblastomas and IDH-mutant astrocytomas showed distinct rCBV and Ktrans values, with Ktrans having the highest AUC (0.73) for predicting IDH status.
Conclusions:
- The 95th percentile of relative cerebral blood volume (rCBV) derived from DSC MRI appears to be the most effective parameter for discriminating between HGGs and LGGs.
- The 95th percentile of the volume transfer constant (Ktrans) from DCE MRI shows promise in predicting the IDH mutational status of diffuse gliomas.
- Combined advanced MRI techniques provide valuable insights into glioma grading and molecular subtyping.
