Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading: Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis

Santarosa, Corrado; Castellano, Antonella; Conte, Gian Marco; Cadioli, Marcello; Iadanza, Antonella; Terreni, Maria Rosa; Franzin, Alberto; Bello, Lorenzo; Caulo, Massimo; Falini, Andrea; Anzalone, Nicoletta

doi:10.1016/j.ejrad.2016.03.020

Cited by 89 publications

(93 citation statements)

References 21 publications

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“…We also found very similar vb for metastasis as reported by Lüdemann et al [10]. Santarosa et al [23] reported the median value of the vp in high-grade glioma similar to this study. In addition, the median and interquartile range of Ktrans in our study groups were also congruent with previously published studies [16,24,25].…”

Section: Discussionsupporting

confidence: 92%

Comparison of Cerebral Blood Volume and Plasma Volume in Untreated Intracranial Tumors

et al. 2016

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PurposePlasma volume and blood volume are imaging-derived parameters that are often used to evaluation intracranial tumors. Physiologically, these parameters are directly related, but their two different methods of measurements, T1-dynamic contrast enhanced (DCE)- and T2-dynamic susceptibility contrast (DSC)-MR utilize different model assumptions and approaches. This poses the question of whether the interchangeable use of T1-DCE-MRI derived fractionated plasma volume (vp) and relative cerebral blood volume (rCBV) assessed using DSC-MRI, particularly in glioblastoma, is reliable, and if this relationship can be generalized to other types of brain tumors. Our goal was to examine the hypothetical correlation between these parameters in three most common intracranial tumor types.MethodsTwenty-four newly diagnosed, treatment naïve brain tumor patients, who had undergone DCE- and DSC-MRI, were classified in three histologically proven groups: glioblastoma (n = 7), meningioma (n = 9), and intraparenchymal metastases (n = 8). The rCBV was obtained from DSC after normalization with the normal-appearing anatomically symmetrical contralateral white matter. Correlations between these parameters were evaluated using Pearson (r), Spearman's (ρ) and Kendall’s tau-b (τB) rank correlation coefficient.ResultsThe Pearson, Spearman and Kendall’s correlation between vp with rCBV were r = 0.193, ρ = 0.253 and τB = 0.33 (p-Pearson = 0.326, p-Spearman = 0.814 and p-Kendall = 0.823) in glioblastoma, r = -0.007, ρ = 0.051 and τB = 0.135 (p-Pearson = 0.970, p-Spearman = 0.765 and p-Kendall = 0.358) in meningiomas, and r = 0.289, ρ = 0.228 and τB = 0.239 (p-Pearson = 0.109, p-Spearman = 0.210 and p-Kendall = 0.095) in metastasis.ConclusionResults indicate that no correlation exists between vp with rCBV in glioblastomas, meningiomas and intraparenchymal metastatic lesions. Consequently, these parameters, as calculated in this study, should not be used interchangeably in either research or clinical practice.

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Section: Discussionsupporting

confidence: 92%

Comparison of Cerebral Blood Volume and Plasma Volume in Untreated Intracranial Tumors

et al. 2016

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“…Two contrast‐enhanced techniques are generally used: dynamic susceptibility contrast (DSC) perfusion and dynamic contrast‐enhanced (DCE) perfusion. DSC perfusion relies on susceptibility‐related loss of T 2 /T 2 * signal during first pass of contrast material bolus through the lesion, while DCE perfusion relies on the dynamic T 1 ‐related signal increase after contrast injection . These techniques provide the radiologist with different parameters to assess lesional perfusion.…”

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confidence: 99%

“…In addition to evaluation of blood volume in a lesion, DCE perfusion allows assessment of the vascular permeability . The complexity of image acquisition and the lack of widely available easy‐to‐use postprocessing software are some of the challenges in the routine application of DCE MR. On the other hand, DSC MR suffers from sensitivity to susceptibility artifacts and effects of contrast leakage; however, it remains the most widely used contrast‐enhanced MR perfusion method . Multiple prior studies have shown the usefulness of DSC and DCE in the assessment of treated HGG, but fewer studies compared these two MR perfusion techniques …”

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confidence: 99%

Prospective comparative diagnostic accuracy evaluation of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) MR perfusion in differentiating tumor recurrence from radiation necrosis in treated high‐grade gliomas

Zakhari

Taccone

Torres

et al. 2019

Magnetic Resonance Imaging

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Background The appearance of a new enhancing lesion after surgery and chemoradiation for high‐grade glioma (HGG) presents a common diagnostic dilemma. Histopathological analysis remains the reference standard in this situation. Purpose To prospectively compare the diagnostic accuracy of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) in differentiating tumor recurrence (TR) from radiation necrosis (RN). Study Type Prospective diagnostic accuracy study. Population In all, 98 consecutive treated HGG patients with new enhancing lesion. We excluded 32 patients due to inadequate follow‐up or technical limitation. Field Strength/Sequence 3 T DCE and DSC MR. Assessment Histogram and hot‐spot analysis of cerebral blood volume (CBV), corrected CBV, Ktrans, area under the curve (AUC), and plasma volume (Vp). The reference standard of TR and/or RN was determined by histopathology in 43 surgically resected lesions or by clinical/imaging follow‐up in the rest. Statistical Tests Mann–Whitney U‐tests, receiver operating characteristic (ROC) curve, and logistic regression analysis. Results A total of 68 lesions were included. There were 37 TR, 28 RN, and three lesions with equal proportions of TR and RN. TR had significantly higher CBV, corrected CBV, CBV ratio, corrected CBV ratio, AUC ratio, and Vp ratio (P < 0.05) than RN on hot‐spot analysis. CBV had the highest diagnostic accuracy (AUROC 0.71). On histogram analysis, TR had higher CBV and corrected CBV maximal value compared with RN (P = 0.006, AUROC = 0.70). Only CBV on hot‐spot analysis remained significant after correction for multiple comparison, with no significant improvement in diagnostic accuracy when using a combination of parameters (AUROC 0.71 vs. 0.76, P = 0.24). Data Conclusion DSC‐derived CBV is the most accurate perfusion parameter in differentiating TR and RN. DSC and DCE‐derived parameters reflecting the blood volume in an enhancing lesion are more accurate than the DCE‐derived parameter Ktrans. Clinical practice may be best guided by blood volume measurements, rather than permeability assessment for differentiation of TR from RN. Level of Evidence: 1 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2019;50:573–582.

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“…DCE has been used for differential diagnosis [55] and tumor grading [56, 57]. Prognostic value of K trans has been particularly investigated, showing a correlation between high baseline levels and poor PFS and OS [58].…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives

Aquino

Gioppo

Finocchiaro

et al. 2017

Journal of Immunology Research

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Pseudophenomena, that is, imaging alterations due to therapy rather than tumor evolution, have an important impact on the management of glioma patients and the results of clinical trials. RANO (response assessment in neurooncology) criteria, including conventional MRI (cMRI), addressed the issues of pseudoprogression after radiotherapy and concomitant chemotherapy and pseudoresponse during antiangiogenic therapy of glioblastomas (GBM) and other gliomas. The development of cancer immunotherapy forced the identification of further relevant response criteria, summarized by the iRANO working group in 2015. In spite of this, the unequivocal definition of glioma progression by cMRI remains difficult particularly in the setting of immunotherapy approaches provided by checkpoint inhibitors and dendritic cells. Advanced MRI (aMRI) may in principle address this unmet clinical need. Here, we discuss the potential contribution of different aMRI techniques and their indications and pitfalls in relation to biological and imaging features of glioma and immune system interactions.

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Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading: Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis

Cited by 89 publications

References 21 publications

Comparison of Cerebral Blood Volume and Plasma Volume in Untreated Intracranial Tumors

Comparison of Cerebral Blood Volume and Plasma Volume in Untreated Intracranial Tumors

Prospective comparative diagnostic accuracy evaluation of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) MR perfusion in differentiating tumor recurrence from radiation necrosis in treated high‐grade gliomas

MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives

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