Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma—a meta-analysis

Delgado, Anna Falk; Luca, F. De; Westen, Danielle van

doi:10.1093/neuonc/noy095

Cited by 40 publications

(38 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They also concluded that rCBF was significantly higher in medulloblastoma compared with pilocytic astrocytoma ( p < 0.05) ( 21 ). Our findings were very consistent with these previous studies ( 18 – 21 ).…”

Section: Discussionsupporting

confidence: 94%

“…Therefore, the accurate diagnosis and grading of gliomas are crucial because these factors influence the decision-making process for treatment and prognosis (11)(12)(13). ASL has been used to evaluate the penumbra area, such as during cerebral infarction, and has also been effective for assessing brain tumors and neurodegenerative disorders, such as Alzheimer's disease, dementia, and Parkinson's disease (16,17). Recently, some studies have shown that ASL-measured CBF can differentiate between low-and high-grade astrocytomas (18,19).…”

Section: Discussionmentioning

confidence: 99%

“…ASL has been used to evaluate the penumbra area, such as during cerebral infarction, and has also been effective for assessing brain tumors and neurodegenerative disorders, such as Alzheimer's disease, dementia, and Parkinson's disease ( 16 , 17 ). Recently, some studies have shown that ASL-measured CBF can differentiate between low- and high-grade astrocytomas ( 18 , 19 ). In our study, the CBF and rCBF values for medulloblastomas compared with pilocytic astrocytomas were 16.02 vs. 9.28 and 0.96 vs. 0.41 ( p < 0.05), respectively.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Three-Dimensional Pseudo-Continuous Arterial Spin Labeling Parameters Distinguish Pediatric Medulloblastoma and Pilocytic Astrocytoma

Duc

2021

Front. Pediatr.

View full text Add to dashboard Cite

Introduction: Arterial Spin Labeling (ASL), a perfusion assessment without using gadolinium-based contrast agents, is outstandingly advantageous for pediatric patients. The differentiation of medulloblastomas from pilocytic astrocytomas in children plays a significant role in determining treatment strategies and prognosis. This study aimed to assess the use of ASL parameters during the differentiation between pediatric medulloblastoma and pilocytic astrocytoma.Methods: The institutional review board of Children's Hospital 2 approved this prospective study. The brain magnetic resonance imaging (MRI) protocol, including axial three-dimensional (3D) pseudo-continuous ASL, was evaluated in 33 patients, who were divided into a medulloblastoma group (n = 25) and a pilocytic astrocytoma group (n = 8). The quantified region of interest (ROI) values for the tumors and the tumor to parenchyma ratios were collected and compared between the two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were utilized to identify the best cut-off, sensitivity, specificity, and area under the curve (AUC) values for significant ASL parameters.Results: The cerebral blood flow (CBF) and the ratio between the CBF of the tumor relative to that of the parenchyma (rCBF) values for medulloblastomas were significantly higher than those for pilocytic astrocytomas (p < 0.05). A cut-off value of 0.51 for rCBF was able to discriminate between medulloblastoma and pilocytic astrocytoma, generating a sensitivity of 88%, a specificity of 75%, and an AUC of 83.5%.Conclusion: The rCBF measurement, obtained during MRI with 3D pseudo-continuous ASL, plays a supplemental role in the differentiation of medulloblastoma from pilocytic astrocytoma.

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Three-Dimensional Pseudo-Continuous Arterial Spin Labeling Parameters Distinguish Pediatric Medulloblastoma and Pilocytic Astrocytoma

Duc

2021

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…It is a widely available and non-invasive medical imaging tool and the only modality to deliver information of brain tissue at a sufficient contrast, spatial and temporal resolution [5,6]. While conventional MRI techniques assess anatomical information about the structure of brain tissue and vasculature, advanced MRI techniques can measure dynamic and functional processes such as perfusion [using arterial spin labeling (ASL), dynamic contrast enhanced (DCE), and dynamic susceptibility contrast (DSC)] [7,8], metabolism [using MR spectroscopy (MRS)] [9], microstructure [using diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM) [10], and other diffusion MRI techniques] [11][12][13], stiffness [using magnetic resonance elastography (MRE)] [14], oxygen extraction [using BOLD-MRI] [15], and vessel architecture [using vessel architectural imaging (VAI)] [16]. Examples of these conventional and advanced MRI techniques are provided in Fig.…”

Section: State-of-the-art Mr Imaging For Gliomamentioning

confidence: 99%

GliMR: Cross-Border Collaborations to Promote Advanced MRI Biomarkers for Glioma

et al. 2020

View full text Add to dashboard Cite

Purpose There is an annual incidence of 50,000 glioma cases in Europe. The optimal treatment strategy is highly personalised, depending on tumour type, grade, spatial localization, and the degree of tissue infiltration. In research settings, advanced magnetic resonance imaging (MRI) has shown great promise as a tool to inform personalised treatment decisions. However, the use of advanced MRI in clinical practice remains scarce due to the downstream effects of siloed glioma imaging research with limited representation of MRI specialists in established consortia; and the associated lack of available tools and expertise in clinical settings. These shortcomings delay the translation of scientific breakthroughs into novel treatment strategy. As a response we have developed the network “Glioma MR Imaging 2.0” (GliMR) which we present in this article. Methods GliMR aims to build a pan-European and multidisciplinary network of experts and accelerate the use of advanced MRI in glioma beyond the current “state-of-the-art” in glioma imaging. The Action Glioma MR Imaging 2.0 (GliMR) was granted funding by the European Cooperation in Science and Technology (COST) in June 2019. Results GliMR’s first grant period ran from September 2019 to April 2020, during which several meetings were held and projects were initiated, such as reviewing the current knowledge on advanced MRI; developing a General Data Protection Regulation (GDPR) compliant consent form; and setting up the website. Conclusion The Action overcomes the pre-existing limitations of glioma research and is funded until September 2023. New members will be accepted during its entire duration.

show abstract

“…29 A recent meta-analysis has demonstrated that ASL is clinically useful in differentiating glioma grades on both PASL and pCASL. Falk Delgado et al 7 analyzed 15 studies with 505 patients and demonstrated that ASL helps to differentiate between high-grade and low-grade gliomas with a summary sensitivity of 0.89 (95% CI 0.79-0.90) and specificity of 0.80 (95% CI 0.72-0.89). High-grade gliomas have a significant increase in all ASL perfusion values such that absolute tumor blood flow and maximum mean relative tumor blood flow aid in grading gliomas.…”

Section: Gliomasmentioning

confidence: 99%

Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Soldozy¹,

Galindo²,

Snyder³

et al. 2019

Neurosurgical Focus

View full text Add to dashboard Cite

Neuroimaging is an indispensable tool in the workup and management of patients with neurological disorders. Arterial spin labeling (ASL) is an imaging modality that permits the examination of blood flow and perfusion without the need for contrast injection. Noninvasive in nature, ASL provides a feasible alternative to existing vascular imaging techniques, including angiography and perfusion imaging. While promising, ASL has yet to be fully incorporated into the diagnosis and management of neurological disorders. This article presents a review of the most recent literature on ASL, with a special focus on its use in moyamoya disease, brain neoplasms, seizures, and migraines and a commentary on recent advances in ASL that make the imaging technique more attractive as a clinically useful tool.

show abstract

Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma—a meta-analysis

Abstract: Arterial spin labeling MR imaging had an excellent diagnostic accuracy for differentiation between high-grade and low-grade glioma. Given its low cost, non-invasiveness, and efficacy, ASL MR imaging should be considered for implementation in the routine workup of patients with glioma.

Cited by 40 publications

References 46 publications

Three-Dimensional Pseudo-Continuous Arterial Spin Labeling Parameters Distinguish Pediatric Medulloblastoma and Pilocytic Astrocytoma

Three-Dimensional Pseudo-Continuous Arterial Spin Labeling Parameters Distinguish Pediatric Medulloblastoma and Pilocytic Astrocytoma

GliMR: Cross-Border Collaborations to Promote Advanced MRI Biomarkers for Glioma

Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Contact Info

Product

Resources

About