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Glioma Grading and Determination of IDH Mutation Status and ATRX loss by DCE and ASL Perfusion

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Abstract

Purpose

To evaluate arterial spin labeling (ASL) perfusion and dynamic contrast-enhanced (DCE) perfusion in glioma grading according to the previous WHO classification of 2007, as well as concerning isocitrate dehydrogenase (IDH) mutation status and ATRX expression as required by the new WHO 2016 brain tumor classification.

Methods

The mean values of Ktrans, Kep, Ve, and Vp by DCE perfusion, and cerebral blood flow (CBF) by ASL perfusion were assessed retrospectively in 40 patients with initial glioma diagnosis. Perfusion parameters were correlated and compared concerning glioma grading, IDH mutation status and ATRX expression.

Results

The DCE and ASL perfusion parameters showed merely moderate correlation. The Ktrans, Ve, and CBF by DCE perfusion were different in low-grade and high-grade gliomas (p = 0.0018, p < 0.0001, and p = 0.0038, respectively). Ve was useful in distinguishing high-grade from low-grade gliomas (p = 0.024, sensitivity = 1.00, specificity = 0.80). CBF by ASL perfusion enabled discrimination of astrocytomas with and without IDH mutation (p = 0.014, sensitivity = 0.75, specificity = 0.88) and showed a trend for the discrimination of astrocytomas with IDH mutation from oligodendrogliomas (p = 0.074).

Conclusion

In conclusion, DCE and ASL perfusion are complementary in the differentiation of gliomas. The discrimination of low- and high-grade gliomas is possible by the DCE perfusion parameter Ve, while ASL perfusion shows potential for the differentiation of the IDH and ATRX mutation status of gliomas following the new WHO classification 2016. Both perfusion techniques might represent different aspects of brain tumor perfusion.

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Acknowledgements

Cornelia Brendle is supported by the TÜFF program of the Faculty of Medicine, Eberhard Karls University Tübingen (application number 2395-0-0).

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Authors and Affiliations

  1. Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany

    Cornelia Brendle, Johann-Martin Hempel, Benjamin Bender, Ulrike Ernemann & Uwe Klose

  2. Neuropathology, Department of Pathology and Neuropathology, Eberhard Karls University, Calwerstr. 3, 72076, Tübingen, Germany

    Jens Schittenhelm

  3. University Department of Neurosurgery, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany

    Marco Skardelly

  4. Interdisciplinary Section of Neurooncology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany

    Ghazaleh Tabatabai

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  1. Cornelia Brendle
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Correspondence to Cornelia Brendle.

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Conflict of interest

The Department of Diagnostic and Interventional Radiology has a collaboration contract with Siemen Healthcare concerning the technical development of PET/MRI Biograph mMR. Otherwise, the authors Cornelia Brendle, Johann-Martin Hempel, Jens Schittenhelm, Marco Skardelly, Ghazaleh Tabatabai, Benjamin Bender, Ulrike Ernemann and Uwe Klose have no conflict of interest.

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Brendle, C., Hempel, JM., Schittenhelm, J. et al. Glioma Grading and Determination of IDH Mutation Status and ATRX loss by DCE and ASL Perfusion. Clin Neuroradiol 28, 421–428 (2018). https://doi.org/10.1007/s00062-017-0590-z

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