Diffusion kurtosis imaging can efficiently assess the glioma grade and cellular proliferation

Abstract

Conventional diffusion imaging techniques are not sufficiently accurate for evaluating glioma grade and cellular proliferation, which are critical for guiding glioma treatment. Diffusion kurtosis imaging (DKI), an advanced non-Gaussian diffusion imaging technique, has shown potential in grading glioma; however, its applications in this tumor have not been fully elucidated. In this study, DKI and diffusion weighted imaging (DWI) were performed on 74 consecutive patients with histopathologically confirmed glioma. The kurtosis and conventional diffusion metric values of the tumor were semi-automatically obtained. The relationships of these metrics with the glioma grade and Ki-67 expression were evaluated. The diagnostic efficiency of these metrics in grading was further compared. It was demonstrated that compared with the conventional diffusion metrics, the kurtosis metrics were more promising imaging markers in distinguishing high-grade from low-grade gliomas and distinguishing among grade II, III and IV gliomas; the kurtosis metrics also showed great potential in the prediction of Ki-67 expression. To our best knowledge, we are the first to reveal the ability of DKI to assess the cellular proliferation of gliomas, and to employ the semi-automatic method for the accurate measurement of gliomas. These results could have a significant impact on the diagnosis and subsequent therapy of glioma.

Diffusion kurtosis imaging of gliomas grades II and III - a study of perilesional tumor infiltration, tumor grades and subtypes at clinical presentation

“…who reported no significant differences in minimum, average or maximum ADC (MD) between ACs grades II and III 39. Our data differs from the recent paper by Jiang et al 24,. who found significant differences in mean kurtosis between glioma grades II and III using a semiautomatic process.…”

Integrative Diffusion-Weighted Imaging and Radiogenomic Network Analysis of Glioblastoma multiforme

“…Most of the samples containing a low FA were identified as proneural samples and showed a significantly better clinical outcome. However, the findings of Jiang et al ., who showed that FA was negatively correlated with KI-6737, a marker of mitosis and hence aggressiveness, seem contradictory. In summary, FA does not seem to be merely attributable to quantitative measures of cellular architecture, but also seems to be related to the expression of specific biological pathways such as the EMT.…”

Texture analysis- and support vector machine-assisted diffusional kurtosis imaging may allow in vivo gliomas grading and IDH-mutation status prediction: a preliminary study

“…showed a high accuracy for the distinction of HGGs from the low-grade gliomas (LGGs) based on mean axial and radial kurtosis values 5,6 . Mean kurtosis has outperformed diagnostically the remainder of the diffusion metrics for grading (WHO grade 2–4) and predicting Ki-67 as a measure of cellularity 7 . Tietze et al .…”