Skip to main content
Erschienen in: Neuroradiology 1/2018

31.10.2017 | Diagnostic Neuroradiology

Differentiation of grade II/III and grade IV glioma by combining “T1 contrast-enhanced brain perfusion imaging” and susceptibility-weighted quantitative imaging

verfasst von: Jitender Saini, Pradeep Kumar Gupta, Prativa Sahoo, Anup Singh, Rana Patir, Suneeta Ahlawat, Manish Beniwal, K. Thennarasu, Vani Santosh, Rakesh Kumar Gupta

Erschienen in: Neuroradiology | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

MRI is a useful method for discriminating low- and high-grade glioma using perfusion MRI and susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of T1-perfusion MRI and SWI in discriminating among grade II, III, and IV gliomas.

Methods

T1-perfusion MRI was used to measure relative cerebral blood volume (rCBV) in 129 patients with glioma (70 grade IV, 33 grade III, and 26 grade II tumors). SWI was also used to measure the intratumoral susceptibility signal intensity (ITSS) scores for each tumor in these patients. rCBV and ITSS values were compared to seek differences between grade II vs. grade III, grade III vs. grade IV, and grade III+II vs. grade IV tumors.

Results

Significant differences in rCBV values of the three grades of the tumors were noted and pairwise comparisons showed significantly higher rCBV values in grade IV tumors as compared to grade III tumors, and similarly increased rCBV was seen in the grade III tumors as compared to grade II tumors (p < 0.001). Grade IV gliomas showed significantly higher ITSS scores on SWI as compared to grade III tumors (p < 0.001) whereas insignificant difference was seen on comparing ITSS scores of grade III with grade II tumors. Combining the rCBV and ITSS resulted in significant improvement in the discrimination of grade III from grade IV tumors.

Conclusion

The combination of rCBV values derived from T1-perfusion MRI and SWI derived ITSS scores improves the diagnostic accuracy for discrimination of grade III from grade IV gliomas.
Literatur
1.
Zurück zum Zitat Law M, Oh S, Babb JS et al (2006) Low-grade gliomas: dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging—prediction of patient clinical response. J Magn Reson Imaging 39:1569–1574 Law M, Oh S, Babb JS et al (2006) Low-grade gliomas: dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging—prediction of patient clinical response. J Magn Reson Imaging 39:1569–1574
2.
Zurück zum Zitat McLendon RE, Halperin EC (2003) Is the long-term survival of patients with intracranial glioblastoma multiforme overstated? Cancer 98:1745–1748CrossRefPubMed McLendon RE, Halperin EC (2003) Is the long-term survival of patients with intracranial glioblastoma multiforme overstated? Cancer 98:1745–1748CrossRefPubMed
3.
Zurück zum Zitat Bergers G, Benjamin LE (2003) Tumorigenesis and the angiogenic switch. Nat Rev Cancer 3:401–410CrossRefPubMed Bergers G, Benjamin LE (2003) Tumorigenesis and the angiogenic switch. Nat Rev Cancer 3:401–410CrossRefPubMed
4.
Zurück zum Zitat Jain R, Ellika SK, Scarpace L et al (2008) Quantitative estimation of permeability surface-area product in astroglial brain tumors using perfusion CT and correlation with histopathologic grade. AJNR Am J Neuroradiol 29:694–700CrossRefPubMed Jain R, Ellika SK, Scarpace L et al (2008) Quantitative estimation of permeability surface-area product in astroglial brain tumors using perfusion CT and correlation with histopathologic grade. AJNR Am J Neuroradiol 29:694–700CrossRefPubMed
5.
Zurück zum Zitat Aronen HJ, Gazit IE, Louis DN et al (1994) Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 191:41–51CrossRefPubMed Aronen HJ, Gazit IE, Louis DN et al (1994) Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 191:41–51CrossRefPubMed
6.
Zurück zum Zitat Law M, Yang S, Wang H et al (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24:1989–1998PubMed Law M, Yang S, Wang H et al (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24:1989–1998PubMed
7.
Zurück zum Zitat Shin JH, Lee HK, Kwun BD et al (2002) Using relative cerebral blood flow and volume to evaluate the histopathologic grade of cerebral gliomas: preliminary results. AJR Am J Roentgenol 179:783–789CrossRefPubMed Shin JH, Lee HK, Kwun BD et al (2002) Using relative cerebral blood flow and volume to evaluate the histopathologic grade of cerebral gliomas: preliminary results. AJR Am J Roentgenol 179:783–789CrossRefPubMed
9.
Zurück zum Zitat Park MJ, Kim HS, Jahng GH, Ryu CW, Park SM, Kim SY (2009) Semiquantitative assessment of intratumoral susceptibility signals using non-contrast-enhanced high-field high-resolution susceptibility-weighted imaging in patients with gliomas: comparison with MR perfusion imaging. AJNR Am J Neuroradiol 30:1402–1408CrossRefPubMed Park MJ, Kim HS, Jahng GH, Ryu CW, Park SM, Kim SY (2009) Semiquantitative assessment of intratumoral susceptibility signals using non-contrast-enhanced high-field high-resolution susceptibility-weighted imaging in patients with gliomas: comparison with MR perfusion imaging. AJNR Am J Neuroradiol 30:1402–1408CrossRefPubMed
10.
Zurück zum Zitat Wang X, Zhang H, Tan Y et al (2014) Combined value of susceptibility-weighted and perfusion-weighted imaging in assessing WHO grade for brain astrocytomas: combined SWI and DSC in brain astrocytomas. J Magn Reson Imaging 39:1569–1574CrossRefPubMed Wang X, Zhang H, Tan Y et al (2014) Combined value of susceptibility-weighted and perfusion-weighted imaging in assessing WHO grade for brain astrocytomas: combined SWI and DSC in brain astrocytomas. J Magn Reson Imaging 39:1569–1574CrossRefPubMed
11.
Zurück zum Zitat Li X, Zhu Y, Kang H et al (2015) Glioma grading by microvascular permeability parameters derived from dynamic contrast-enhanced MRI and intratumoral susceptibility signal on susceptibility weighted imaging. Cancer Imaging 15:4CrossRefPubMedPubMedCentral Li X, Zhu Y, Kang H et al (2015) Glioma grading by microvascular permeability parameters derived from dynamic contrast-enhanced MRI and intratumoral susceptibility signal on susceptibility weighted imaging. Cancer Imaging 15:4CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Ohgaki H, Kleihues P (2005) Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 64:479–489CrossRefPubMed Ohgaki H, Kleihues P (2005) Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 64:479–489CrossRefPubMed
13.
Zurück zum Zitat Le Rhun E, Taillibert S, Chamberlain MC (2016) Current management of adult diffuse infiltrative low grade gliomas. Curr Neurol Neurosci Rep 16:15CrossRefPubMed Le Rhun E, Taillibert S, Chamberlain MC (2016) Current management of adult diffuse infiltrative low grade gliomas. Curr Neurol Neurosci Rep 16:15CrossRefPubMed
14.
Zurück zum Zitat Wang Y, Jiang T (2013) Understanding high grade glioma: molecular mechanism, therapy and comprehensive management. Cancer Lett 331:139–146CrossRefPubMed Wang Y, Jiang T (2013) Understanding high grade glioma: molecular mechanism, therapy and comprehensive management. Cancer Lett 331:139–146CrossRefPubMed
15.
Zurück zum Zitat Collet S, Valable S, Constans JM et al (2015) [(18)F]-fluoro-L-thymidine PET and advanced MRI for preoperative grading of gliomas. Neuroimage Clin 8:448–454CrossRefPubMedPubMedCentral Collet S, Valable S, Constans JM et al (2015) [(18)F]-fluoro-L-thymidine PET and advanced MRI for preoperative grading of gliomas. Neuroimage Clin 8:448–454CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Wiestler B, Kluge A, Lukas M et al (2016) Multiparametric MRI-based differentiation of WHO grade II/III glioma and WHO grade IV glioblastoma. Sci Rep 6:35142CrossRefPubMedPubMedCentral Wiestler B, Kluge A, Lukas M et al (2016) Multiparametric MRI-based differentiation of WHO grade II/III glioma and WHO grade IV glioblastoma. Sci Rep 6:35142CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Falk A, Fahlström M, Rostrup E et al (2014) 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. Neuroradiology 56:1031–1038CrossRefPubMed Falk A, Fahlström M, Rostrup E et al (2014) 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. Neuroradiology 56:1031–1038CrossRefPubMed
18.
Zurück zum Zitat Singh A, Haris M, Rathore D et al (2007) Quantification of physiological and hemodynamic indices using T(1) dynamic contrast-enhanced MRI in intracranial mass lesions. J Magn Reson Imaging 26:871–880CrossRefPubMed Singh A, Haris M, Rathore D et al (2007) Quantification of physiological and hemodynamic indices using T(1) dynamic contrast-enhanced MRI in intracranial mass lesions. J Magn Reson Imaging 26:871–880CrossRefPubMed
19.
Zurück zum Zitat Sahoo P, Rathore RKS, Awasthi R et al (2013) Subcompartmentalization of extracellular extravascular space (EES) into permeability and leaky space with local arterial input function (AIF) results in improved discrimination between high- and low-grade glioma using dynamic contrast-enhanced (DCE) MRI. J Magn Reson Imaging 38:677–688CrossRefPubMed Sahoo P, Rathore RKS, Awasthi R et al (2013) Subcompartmentalization of extracellular extravascular space (EES) into permeability and leaky space with local arterial input function (AIF) results in improved discrimination between high- and low-grade glioma using dynamic contrast-enhanced (DCE) MRI. J Magn Reson Imaging 38:677–688CrossRefPubMed
20.
Zurück zum Zitat Cha S, Johnson G, Wadghiri YZ et al (2003) Dynamic, contrast-enhanced perfusion MRI in mouse gliomas: correlation with histopathology. Magn Reson Med 49:848–855CrossRefPubMed Cha S, Johnson G, Wadghiri YZ et al (2003) Dynamic, contrast-enhanced perfusion MRI in mouse gliomas: correlation with histopathology. Magn Reson Med 49:848–855CrossRefPubMed
21.
Zurück zum Zitat Jain RK, di Tomaso E, Duda DG, Loeffler JS, Sorensen AG, Batchelor TT (2007) Angiogenesis in brain tumours. Nat Rev Neurosci 8:610–622CrossRefPubMed Jain RK, di Tomaso E, Duda DG, Loeffler JS, Sorensen AG, Batchelor TT (2007) Angiogenesis in brain tumours. Nat Rev Neurosci 8:610–622CrossRefPubMed
22.
Zurück zum Zitat Lacerda S, Law M (2009) Magnetic resonance perfusion and permeability imaging in brain tumors. Neuroimaging Clin N Am 19:527–557CrossRefPubMed Lacerda S, Law M (2009) Magnetic resonance perfusion and permeability imaging in brain tumors. Neuroimaging Clin N Am 19:527–557CrossRefPubMed
23.
Zurück zum Zitat Sugahara T, Korogi Y, Kochi M et al (1998) Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol 171:1479–1486CrossRefPubMed Sugahara T, Korogi Y, Kochi M et al (1998) Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol 171:1479–1486CrossRefPubMed
24.
Zurück zum Zitat Sahoo P, Gupta RK, Gupta PK et al (2017) Diagnostic accuracy of automatic normalization of CBV in glioma grading using T1- weighted DCE-MRI. Magn Reson Imaging 44:32–37CrossRefPubMed Sahoo P, Gupta RK, Gupta PK et al (2017) Diagnostic accuracy of automatic normalization of CBV in glioma grading using T1- weighted DCE-MRI. Magn Reson Imaging 44:32–37CrossRefPubMed
25.
26.
Zurück zum Zitat Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed
27.
28.
Zurück zum Zitat Hirai T, Murakami R, Nakamura H et al (2008) Prognostic value of perfusion MR imaging of high-grade astrocytomas: long-term follow-up study. AJNR Am J Neuroradiol 29:1505–1510CrossRefPubMed Hirai T, Murakami R, Nakamura H et al (2008) Prognostic value of perfusion MR imaging of high-grade astrocytomas: long-term follow-up study. AJNR Am J Neuroradiol 29:1505–1510CrossRefPubMed
29.
Zurück zum Zitat Zonari P, Baraldi P, Crisi G (2007) Multimodal MRI in the characterization of glial neoplasms: the combined role of single-voxel MR spectroscopy, diffusion imaging and echo-planar perfusion imaging. Neuroradiology 49:795–803CrossRefPubMed Zonari P, Baraldi P, Crisi G (2007) Multimodal MRI in the characterization of glial neoplasms: the combined role of single-voxel MR spectroscopy, diffusion imaging and echo-planar perfusion imaging. Neuroradiology 49:795–803CrossRefPubMed
30.
Zurück zum Zitat Chan AS, Leung SY, Wong MP et al (1998) Expression of vascular endothelial growth factor and its receptors in the anaplastic progression of astrocytoma, oligodendroglioma, and ependymoma. Am J Surg Pathol 22:816–826CrossRefPubMed Chan AS, Leung SY, Wong MP et al (1998) Expression of vascular endothelial growth factor and its receptors in the anaplastic progression of astrocytoma, oligodendroglioma, and ependymoma. Am J Surg Pathol 22:816–826CrossRefPubMed
31.
Zurück zum Zitat Lev MH, Ozsunar Y, Henson JW et al (2004) Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol 25:214–221PubMed Lev MH, Ozsunar Y, Henson JW et al (2004) Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol 25:214–221PubMed
32.
Zurück zum Zitat Furtner J, Schöpf V, Preusser M et al (2014) Non-invasive assessment of intratumoral vascularity using arterial spin labeling: a comparison to susceptibility-weighted imaging for the differentiation of primary cerebral lymphoma and glioblastoma. Eur J Radiol 83:806–810CrossRefPubMed Furtner J, Schöpf V, Preusser M et al (2014) Non-invasive assessment of intratumoral vascularity using arterial spin labeling: a comparison to susceptibility-weighted imaging for the differentiation of primary cerebral lymphoma and glioblastoma. Eur J Radiol 83:806–810CrossRefPubMed
33.
Zurück zum Zitat Li C, Ai B, Li Y, Qi H, Wu L (2010) Susceptibility-weighted imaging in grading brain astrocytomas. Eur J Radiol 75:e81–e85CrossRefPubMed Li C, Ai B, Li Y, Qi H, Wu L (2010) Susceptibility-weighted imaging in grading brain astrocytomas. Eur J Radiol 75:e81–e85CrossRefPubMed
34.
Zurück zum Zitat Pinker K, Noebauer-Huhmann IM, Stavrou I et al (2007) High-resolution contrast-enhanced, susceptibility-weighted MR imaging at 3T in patients with brain tumors: correlation with positron-emission tomography and histopathologic findings. AJNR Am J Neuroradiol 28:1280–1286CrossRefPubMed Pinker K, Noebauer-Huhmann IM, Stavrou I et al (2007) High-resolution contrast-enhanced, susceptibility-weighted MR imaging at 3T in patients with brain tumors: correlation with positron-emission tomography and histopathologic findings. AJNR Am J Neuroradiol 28:1280–1286CrossRefPubMed
35.
Zurück zum Zitat van den Bent MJ (2010) Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective. Acta Neuropathol 120:297–304CrossRefPubMedPubMedCentral van den Bent MJ (2010) Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective. Acta Neuropathol 120:297–304CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Christoforidis GA, Kangarlu A, Abduljalil AM et al (2004) Susceptibility-based imaging of glioblastoma microvascularity at 8 T: correlation of MR imaging and postmortem pathology. AJNR Am J Neuroradiol 25:756–760PubMedPubMedCentral Christoforidis GA, Kangarlu A, Abduljalil AM et al (2004) Susceptibility-based imaging of glioblastoma microvascularity at 8 T: correlation of MR imaging and postmortem pathology. AJNR Am J Neuroradiol 25:756–760PubMedPubMedCentral
37.
Zurück zum Zitat Reuss DE, Mamatjan Y, Schrimpf D et al (2015) IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol 129:867–873CrossRefPubMedPubMedCentral Reuss DE, Mamatjan Y, Schrimpf D et al (2015) IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol 129:867–873CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Hartmann C, Hentschel B, Wick W et al (2010) Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 120:707–718CrossRefPubMed Hartmann C, Hentschel B, Wick W et al (2010) Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 120:707–718CrossRefPubMed
39.
Zurück zum Zitat Lee S, Choi SH, Ryoo I et al (2015) Evaluation of the microenvironmental heterogeneity in high-grade gliomas with IDH1/2 gene mutation using histogram analysis of diffusion-weighted imaging and dynamic-susceptibility contrast perfusion imaging. J Neuro-Oncol 121:141–150CrossRef Lee S, Choi SH, Ryoo I et al (2015) Evaluation of the microenvironmental heterogeneity in high-grade gliomas with IDH1/2 gene mutation using histogram analysis of diffusion-weighted imaging and dynamic-susceptibility contrast perfusion imaging. J Neuro-Oncol 121:141–150CrossRef
Metadaten
Titel
Differentiation of grade II/III and grade IV glioma by combining “T1 contrast-enhanced brain perfusion imaging” and susceptibility-weighted quantitative imaging
verfasst von
Jitender Saini
Pradeep Kumar Gupta
Prativa Sahoo
Anup Singh
Rana Patir
Suneeta Ahlawat
Manish Beniwal
K. Thennarasu
Vani Santosh
Rakesh Kumar Gupta
Publikationsdatum
31.10.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Neuroradiology / Ausgabe 1/2018
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-017-1942-8

Weitere Artikel der Ausgabe 1/2018

Neuroradiology 1/2018 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.