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Dynamic Contrast‐Enhanced Perfusion MRI and Diffusion‐Weighted Imaging in Grading of Gliomas
Author(s) -
ArevaloPerez Julio,
Peck Kyung K.,
Young Robert J.,
Holodny Andrei I.,
Karimi Sasan,
Lyo John K.
Publication year - 2015
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12239
Subject(s) - medicine , grading (engineering) , glioma , nuclear medicine , diffusion mri , perfusion , effective diffusion coefficient , tumor grade , magnetic resonance imaging , radiology , perfusion scanning , mann–whitney u test , cancer , civil engineering , cancer research , engineering
PURPOSE Accurate glioma grading is crucial for treatment planning and predicting prognosis. We performed a quantitative volumetric analysis to assess the diagnostic accuracy of histogram analysis of diffusion‐weighted imaging (DWI) and dynamic contrast‐enhanced (DCE) T1‐weighted perfusion imaging in the preoperative evaluation of gliomas. METHODS Sixty‐three consecutive patients with pathologically confirmed gliomas who underwent baseline DWI and DCE‐MRI were enrolled. The patients were classified by histopathology according to tumor grade: 20 low‐grade gliomas (grade II) and 43 high‐grade gliomas (grades III and IV). Volumes‐of‐interest were calculated and transferred to DCE perfusion and apparent diffusion coefficient (ADC) maps. Histogram analysis was performed to determine mean and maximum values for V p and K trans , and mean and minimum values for ADC. Comparisons between high‐grade and low‐grade gliomas, and between grades II, III, and IV, were performed. A Mann‐Whitney U test at a significance level of corrected P ≤ .01 was used to assess differences. RESULTS All perfusion parameters could differentiate between high‐grade and low‐grade gliomas ( P < .001) and between grades II and IV, grades II and III, and grades III and IV. Significant differences in minimum ADC were also found ( P < .01). Mean ADC only differed significantly between high and low grades and grades II and IV ( P < .01). There were no differences between grades II and III ( P = .1) and grades III and IV ( P = .71). CONCLUSION When derived from whole‐tumor histogram analysis, DCE‐MRI perfusion parameters performed better than ADC in noninvasively discriminating low‐ from high‐grade gliomas.