Open AccessHigh grade gliomas: The role of dynamic contrast-enhanced susceptibility-weighted perfusion MRI and proton MR spectroscopic imaging in differentiating grade III from grade IV
Author(s) -
Sayed Zidan,
Hazim I. Tantawy,
Mansour Abdelmagid Makia
Publication year - 2016
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2016.10.002
Subject(s) - glioma , grading (engineering) , medicine , cerebral blood volume , nuclear medicine , perfusion , dynamic contrast enhanced mri , magnetic resonance imaging , radiology , civil engineering , cancer research , engineering
BackgroundAdvanced MR imaging techniques provide physiologic information which complements the conventional MRI findings.PurposeTo evaluate the role of dynamic contrast-enhanced perfusion MRI and proton MR spectroscopy (MRS) in differentiating grade-III from grade-IV glioma.Results40 patients with preliminary diagnosis of glioma according to the conventional MRI study and the WHO classification and grading of glioma underwent dynamic MRI study which revealed, 19 patients (47.5%) are diagnosed as grade-III, and 21 cases (52.5%) are diagnosed as grade-IV. The tumor core relative cerebral blood volume (rCBV) was highly significant (P=0.000) in differentiating grade III from grade IV with cutoff value of 6,sensitivity of 90.5%, specificity of 68.4%, PVP of 76% and NPV of 86.7%.In proton MR spectroscopy, (CHo/Cr) ratio was significant in differentiating grade III from grade IV glioma (P=0.02), while CHo/NAA, NAA/Cr and MI/Cr ratios were not significant.ConclusionThe rCBV estimation and the metabolite ratios separately or in combination increase the sensitivity of grading of glioma rather than the conventional MRI