Adding DSC PWI and DWI to BT-RADS can help identify postoperative recurrence in patients with high-grade gliomas

Yang, Yuelong; Yang, Yishi; Wu, Xiaoling; Pan, Yi; Zhou, Dong; Zhang, Hongdan; Yong-lu, Chen; Jin, Zhao; Mo, Zihua; Huang, Biao

doi:10.1007/s11060-019-03387-6

Cited by 21 publications

(21 citation statements)

References 26 publications

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“…The DSC-MRI has been widely used in evaluation of the suspicious lesions in posttreatment glioma patients [ 5 , 18 – 20 ]. The rCBV cutoff is important for identifying true progression.…”

Section: Discussionmentioning

confidence: 99%

“…In spite of the difference of cutoff value of rCBV, the diagnostic performance of our study was similar to other authors' [ 8 , 19 ]. This indicted DSC-MRI, in spite of diverse rCBV cutoff value, can be used to improve the evaluation of progression in glioma patients after treatment [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The role of DWI in differentiating true progression from pseudoprogression lesions remains ambiguous. Most studies showed the accuracy of ADC value in the differentiation was the lowest among all functional MR techniques [ 5 , 8 , 23 ]. The treatment effects, such as gliosis, coagulation necrosis, macrophages invasion, and demyelination, can reduce ADC value.…”

Section: Discussionmentioning

confidence: 99%

“…As a golden standard, histopathology is limited in clinical practice for the disadvantage of invasive sampling, sampling error, and high cost [ 5 ]. MRI is the most common modality of follow-up tool in patients with posttreatment glioma.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that MR perfusion-weighted imaging, especially dynamic susceptibility contrast perfusion MRI (DSC-MRI), can reflect tumor angiogenesis which is valuable for glioma grading, estimation of prognosis, and differentiating tumor recurrence from treatment-related changes [ 5 , 9 , 10 ]. But there are only a few reports that assessed the impact of combined DSC-MRI and other MRI features on identifying the true tumor progression [ 5 , 9 , 11 ]. Since functional MR imaging techniques can reflect different pathological changes, such as diffusion-weighted imaging (DWI) for water molecule movement, and magnetic resonance spectroscopy (MRS) for neoplastic metabolites, we hypothesized that combination of DSC-MRI, DWI, and MRS can improve the accuracy for identification of true progression lesions among the gadolinium-enhancing lesions.…”

Section: Introductionmentioning

confidence: 99%

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Role of Dynamic Susceptibility Contrast Perfusion MRI in Glioma Progression Evaluation

Guanmin

Zhang

Liu

et al. 2021

Journal of Oncology

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Accurately and quickly differentiating true progression from pseudoprogression in glioma patients is still a challenge. This study aims to explore if dynamic susceptibility contrast- (DSC-) MRI can improve the evaluation of glioma progression. We enrolled 65 glioma patients with suspected gadolinium-enhancing lesion. Longitudinal MRI follow-up (mean 590 days, range: 210–2670 days) or re-operation (n = 3) was used to confirm true progression (n = 51) and pseudoprogression (n = 14). We assessed the diagnostic performance of each MRI variable and the different combinations. Our results showed that the relative cerebral blood volume (rCBV) in the true progression group (1.094, 95%CI: 1.135–1.636) was significantly higher than that of the pseudoprogression group (0.541 ± 0.154) p < 0.001 . Among the 18 patients who had serial DSC-MRI, the rCBV of the progression group (0.480, 95%CI: 0.173–0.810) differed significantly from pseudoprogression (-0.083, 95%CI: −1.138–0.620) group p = 0.015 . With an rCBV threshold of 0.743, the sensitivity and specificity for discriminating true progression from pseudoprogression were 76.5% and 92.9%, respectively. The Cho/Cr and Cho/NAA ratios of the true progression group (2.520, 95%CI: 2.331–2.773; 2.414 ± 0.665, respectively) were higher than those of the pseudoprogression group (1.719 ± 0.664; 1.499 ± 0.500, respectively) ( p = 0.001 , p < 0.001 , respectively). The areas under ROC curve (AUCs) of enhancement pattern, MRS, and DSC-MRI for the differentiation were 0.782, 0.881, and 0.912, respectively. Interestingly, when combined enhancement pattern, MRS, and DSC-MRI variables, the AUC was 0.965 and achieved sensitivity 90.2% and specificity 100.0%. Our results suggest that DSC-MRI can significantly improve the diagnostic performance for identifying glioma progression. DSC-MRI combined with conventional MRI may promptly distinguish true gliomas progression from pseudoprogression when the suspected gadolinium-enhancing lesion was found, without the need for a long-term follow-up.

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“…The DSC-MRI has been widely used in evaluation of the suspicious lesions in posttreatment glioma patients [ 5 , 18 – 20 ]. The rCBV cutoff is important for identifying true progression.…”

Section: Discussionmentioning

confidence: 99%