Related Experiment Video
Updated: Jun 25, 2025
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Differentiating Low-Grade from High-Grade Intracranial Ependymomas: Comparison of Dynamic Contrast-Enhanced MRI and
Julio Arevalo-Perez1, Elena Yllera-Contreras2, Kyung K Peck3
1From the Department of Radiology (J.A.-P., E.Y.-C., V.H., O.Y., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York arevalj1@mskcc.org.
Background And Purpose:
The aim of this study was to determine the diagnostic value of fractional plasma volume derived from dynamic contrast-enhanced perfusion MR imaging versus ADC, obtained from DWI in differentiating between grade 2 (low-grade) and grade 3 (high-grade) intracranial ependymomas.
Materials And Methods:
A hospital database was created for the period from January 2013 through June 2022, including patients with histologically-proved ependymoma diagnosis with available dynamic contrast-enhanced MR imaging. Both dynamic contrast-enhanced perfusion and DWI were performed on each patient using 1.5T and 3T scanners. Fractional plasma volume maps and ADC maps were calculated. ROIs were defined by a senior neuroradiologist manually by including the enhancing tumor on every section and conforming a VOI to obtain the maximum value of fractional plasma volume (Vpmax) and the minimum value of ADC (ADCmin). A Mann-Whitney U test at a significance level of corrected P = .01 was used to evaluate the differences. Additionally, receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of Vpmax and ADCmin values.
Results:
A total of 20 patients with ependymomas (10 grade 2 tumors and 10 grade 3 tumors) were included. Vpmax values for grade 3 ependymomas were significantly higher (P < .002) than those for grade 2. ADCmin values were overall lower in high-grade lesions. However, no statistically significant differences were found (P = .12114).
Conclusions:
As a dynamic contrast-enhanced perfusion MR imaging metric, fractional plasma volume can be used as an indicator to differentiate grade 2 and grade 3 ependymomas. Dynamic contrast-enhanced perfusion MR imaging plays an important role with high diagnostic value in differentiating low- and high-grade ependymoma.
Insights
Fractional plasma volume from dynamic contrast-enhanced perfusion MRI is a valuable indicator for differentiating low-grade (grade 2) and high-grade (grade 3) ependymomas. This perfusion imaging metric shows higher values in high-grade tumors, aiding in diagnosis.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Ependymomas are primary brain tumors with varying grades impacting prognosis.
- Accurate grading of ependymomas is crucial for treatment planning and patient outcomes.
- Distinguishing between low-grade (grade 2) and high-grade (grade 3) ependymomas can be challenging with conventional imaging.
Purpose of the Study:
- To evaluate the diagnostic utility of fractional plasma volume (Vpmax) from dynamic contrast-enhanced perfusion MRI.
- To compare Vpmax with apparent diffusion coefficient (ADCmin) from diffusion-weighted imaging (DWI) in differentiating ependymoma grades.
- To determine if perfusion MRI can reliably distinguish between grade 2 and grade 3 intracranial ependymomas.
Main Methods:
- Retrospective analysis of 20 patients with histologically confirmed ependymomas (10 grade 2, 10 grade 3).
- Acquisition of dynamic contrast-enhanced perfusion MRI and DWI on 1.5T and 3T scanners.
- Calculation of Vpmax and ADCmin values from manually defined regions of interest by a senior neuroradiologist.
- Statistical analysis using Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis.
Main Results:
- Significantly higher Vpmax values were observed in grade 3 ependymomas compared to grade 2 ependymomas (P < .002).
- ADCmin values were generally lower in high-grade lesions, but the difference was not statistically significant (P = .12114).
- Vpmax demonstrated potential as a differentiator between ependymoma grades.
Conclusions:
- Fractional plasma volume derived from dynamic contrast-enhanced perfusion MRI serves as a significant indicator for differentiating grade 2 and grade 3 ependymomas.
- Dynamic contrast-enhanced perfusion MRI offers high diagnostic value in distinguishing between low- and high-grade ependymomas.
- Perfusion MRI metrics like Vpmax may be superior to ADCmin in grading intracranial ependymomas.
