Discrimination between glioma grades II and III in suspected low-grade gliomas using dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging: a histogram analysis approach

Falk, Anna; Fahlström, Markus; Rostrup, Egill; Berntsson, Shala Ghaderi; Zetterling, Maria; Morell, Arvid; Larsson, Henrik; Smits, Anja; Larsson, Elna‐Marie

doi:10.1007/s00234-014-1426-z

Cited by 55 publications

(51 citation statements)

References 24 publications

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“…Previous studies in adult brain tumors have shown that higher-grade tumors have increased values of blood-brain barrier permeability measures like K trans , V e , and K ep [14,27,28] and these parameters were found to be useful for grading of gliomas. Vajapeyam et al [8] , in their recently published study, reported higher K trans and K ep values and lower V e values in higher-grade pediatric tumors.…”

Section: Discussionmentioning

confidence: 99%

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Gupta¹,

Saini²,

Sahoo³

et al. 2017

Pediatr Neurosurg

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Background/Aims: Perfusion magnetic resonance imaging (MRI) is useful for preoperative assessment of brain tumors. Dynamic susceptibility contrast perfusion MRI is commonly used for evaluation of brain tumors. Dynamic contrast-enhanced (DCE) MRI is an alternative method that has mainly been used in adult brain tumors. In this preliminary study, we report our initial experience with the DCE perfusion MRI in pediatric brain tumors. Methods: Sixty-four newly diagnosed pediatric brain tumor patients underwent DCE perfusion MRI on a 3-T scanner. Hemodynamic and kinetic parametric maps were generated and the regions with the highest values were measured on each map. Statistical differences were sought to differentiate between low-grade tumors, high-grade tumors, and medulloblastomas. The perfusion metrics of common posterior fossa tumors were also compared. Results: Relative corrected cerebral blood volume (rCBV) and fractional plasma volume measures differed significantly between high- and low-grade tumors (p < 0.05). High-grade tumors could be differentiated from low-grade tumors, with an rCBV cutoff value of 2.41 and 88.6% sensitivity and 65% specificity. There was no significant difference in K^trans, K_ep, V_e, or λ^tr between these 2 groups of tumors. rCBV, relative quantification of the cerebral blood flow, and permeability indices were found to be significantly different in various posterior fossa tumors, i.e., pilocytic astrocytoma, ependymoma, and medulloblastoma (p < 0.05). Conclusion: DCE-derived perfusion metrics are useful in differentiating high-grade tumors from low-grade ones and discriminating among various posterior fossa tumors in the pediatric age group.

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Section: Discussionmentioning

confidence: 99%

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Gupta¹,

Saini²,

Sahoo³

et al. 2017

Pediatr Neurosurg

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“…Morphological imaging included axial and coronal T2-weighted fluid attenuated inversion recovery (FLAIR) scans (0.45 × 0.45 × 6 mm 3 voxel size). Dynamic susceptibility contrast (DSC) perfusion imaging was performed as previously described [24], with a T2*W single-shot gradient echo-EPI sequence (1.7 × 2.3 × 5.0 mm 3 ). Whole-brain coverage was obtained using these parameters.…”

Section: Pet and Mri Acquisitionmentioning

confidence: 99%

“…DSC perfusion was analyzed as previously described [24], with calculation of CBV maps using nordicICE software (NordicNeuroLab AS, Bergen, Norway). Relative CBV (rCBV) was calculated as tumor-to-normal tissue (T/N) ratio by dividing the mean CBV in ROIs defined on PET, with the mean CBV within a reference area located in normal appearing white matter of the contralateral hemisphere above and lateral to the ventricle.…”

Section: Mri Perfusion Analysismentioning

confidence: 99%

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Roodakker

Alhuseinalkhudhur

Al-Jaff

et al. 2018

Eur J Nucl Med Mol Imaging

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Purpose Oligodendrogliomas are heterogeneous tumors in terms of imaging appearance, and a deeper understanding of the histopathological tumor characteristics in correlation to imaging parameters is needed. We used PET-to-MRI-to-histology coregistration with the aim of studying intra-tumoral 11 C-methionine (MET) uptake in relation to tumor perfusion and the protein expression of histological cell markers in corresponding areas. Methods Consecutive histological sections of four tumors covering the entire en bloc-removed tumor were immunostained with antibodies against IDH1-mutated protein (tumor cells), Ki67 (proliferating cells), and CD34 (blood vessels). Software was developed for anatomical landmarks-based co-registration of subsequent histological images, which were overlaid on corresponding MET PET scans and MRI perfusion maps. Regions of interest (ROIs) on PET were selected throughout the entire tumor volume, covering hot spot areas, areas adjacent to hot spots, and tumor borders with infiltrating zone. Tumor-to-normal tissue (T/ N) ratios of MET uptake and mean relative cerebral blood volume (rCBV) were measured in the ROIs and protein expression of histological cell markers was quantified in corresponding regions. Statistical correlations were calculated between MET uptake, rCBV, and quantified protein expression. Results A total of 84 ROIs were selected in four oligodendrogliomas. A significant correlation (p < 0.05) between MET uptake and tumor cell density was demonstrated in all tumors separately. In two tumors, MET correlated with the density of proliferating cells and vessel cell density. There were no significant correlations between MET uptake and rCBV, and between rCBV and histological cell markers. Conclusions The MET uptake in hot spots, outside hotspots, and in infiltrating tumor edges unanimously reflects tumor cell density. The correlation between MET uptake and vessel density and density of proliferating cells is less stringent in infiltrating tumor edges and is probably more susceptible to artifacts caused by larger blood vessels surrounding the tumor. Although based on a limited number of samples, this study provides histological proof for MET as an indicator of tumor cell density and for the lack of statistically significant correlations between rCBV and histological cell markers in oligodendrogliomas.

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“…It was reported that approximately 20 % of LGGs enhanced after the administration of a gadolinium-based contrast agent, whereas 14 %-45 % of nonenhancing gliomas were histologically proved to be HGGs [6,7]. It was reported that diffusion-weighted (DW) or PW imaging could differentiate HGGs from LGGs in nonenhancing gliomas [8,9], but no consensus has been reached in light of the limited number of studies.…”

Section: Introductionmentioning

confidence: 97%

Grading diffuse gliomas without intense contrast enhancement by amide proton transfer MR imaging: comparisons with diffusion- and perfusion-weighted imaging

et al. 2016

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Discrimination between glioma grades II and III in suspected low-grade gliomas using dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging: a histogram analysis approach

Abstract: Histogram parameters from k(trans) (DCE) and rCBF (DSC) could most efficiently discriminate between grade II and grade III gliomas.

Cited by 55 publications

References 24 publications

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Grading diffuse gliomas without intense contrast enhancement by amide proton transfer MR imaging: comparisons with diffusion- and perfusion-weighted imaging

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