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Intravoxel incoherent motion diffusion‐weighted imaging analysis of diffusion and microperfusion in grading gliomas and comparison with arterial spin labeling for evaluation of tumor perfusion
Author(s) -
Shen Nanxi,
Zhao Lingyun,
Jiang Jingjing,
Jiang Rifeng,
Su Changliang,
Zhang Shun,
Tang Xiangyu,
Zhu Wenzhen
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25191
Subject(s) - intravoxel incoherent motion , medicine , grading (engineering) , diffusion mri , perfusion , arterial spin labeling , nuclear medicine , radiology , nuclear magnetic resonance , magnetic resonance imaging , physics , engineering , civil engineering
Purpose To determine the utility of intravoxel incoherent motion (IVIM) imaging in grading gliomas and compare IVIM perfusion metrics with arterial spin labeling (ASL)‐derived cerebral blood flow (CBF). Materials and Methods Fifty‐two patients with pathologically confirmed gliomas underwent IVIM and ASL imaging at 3.0T. IVIM perfusion‐related diffusivity (D*), perfusion fraction (f), product of f and D*(f×D*), true diffusivity (D), and apparent diffusion coefficient (ADC) were obtained to distinguish glioma grades. The CBF derived from pseudocontinuous ASL within the solid tumor was compared and correlated with IVIM perfusion metrics for grading of gliomas. Values were also normalized to the contralateral normal‐appearing white matter. Receiver‐operating characteristic was performed to determine diagnostic efficiency. The reliability was estimated with intraclass coefficient, coefficient of variance, and Bland–Altman plots. Results IVIM perfusion metrics and CBF were significantly higher in the high‐grade than the low‐grade gliomas ( P < 0.001), ADC and D were significantly lower in the high‐grade than the low‐grade gliomas ( P < 0.001). f×D* differed significantly between grades II through IV ( P < 0.05 for all). The other metrics showed significant difference between grade II and grade III ( P < 0.05 for all). Area under the curve (AUC) was largest for f×D* in distinguishing high‐grade from low‐grade gliomas (AUC = 0.979, P < 0.001) and between grade II and grade III (AUC = 0.957, P < 0.001). f×D* improved diagnostic performance of CBF in grading gliomas and showed strong correlation with CBF ( r = 0.696, P < 0.001). Conclusion IVIM‐derived metrics are promising biomarkers in preoperative grading gliomas. IVIM imaging may be an additive method to ASL and ADC for evaluating tumor perfusion and diffusion. J. Magn. Reson. Imaging 2016;44:620–632.