Correlation between dynamic MRI and outcome in patients with malignant gliomas

Wong, Eric T.; Jackson, Edward F.; Hess, KR; Schomer, Donald F.; Hazle, John D.; Kyritsis, Athanassios P.; Jaeckle, Kurt A.; Yung, W. K. Alfred; Levin, V. A.; Leeds, Norman E.

doi:10.1212/wnl.50.3.777

Cited by 38 publications

(18 citation statements)

References 6 publications

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“…Previous studies have shown correlations between MR parameters and clinical outcome. Lin et al (31) showed that high Cho levels indicate poor survival, and Wong et al (32) found a correlation of higher maximum rate of gadolinium obtained from dynamic MRI with shorter survival. In future studies, we will examine the prognostic significance of the volumes of the morphologic and metabolic abnormalities and the signal levels in the most abnormal regions by correlating them with clinical outcomes as defined by time to progression and survival.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patients

Lü

Pirzkall

et al. 2002

Magnetic Resonance Imaging

112

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Purpose:To evaluate the role of 3D MR spectroscopic imaging (MRSI) as a tool for characterizing heterogeneity within a lesion in glioma patients. Materials and Methods:Forty-nine patients with newly diagnosed glioma were studied with 3D water-suppressed proton (1-H) MRSI. Signal intensities from choline (Cho), creatine (Cr), N-acytel aspartate (NAA), and lactate/lipid (LL) were estimated from the spectra. Regions of interest (ROIs) corresponding to the metabolic abnormalities were defined and compared with the anatomic lesions.Results: This study showed that the tumor burden measured with either the volumes of the metabolic abnormalities or the metabolic levels in the most abnormal voxels was correlated with the degree of malignancy of the tumor. The volumes of elevated Cho and decreased NAA were useful for distinguishing low-grade from high-grade lesions. The volume of abnormal LL was correlated with the existence of necrosis and with the volume of contrast-enhancing lesions in high-grade lesions. The differences in the volume of abnormal LL were also statistically significant between patients in each grade. Conclusion:These 3D-MRSI data provide important additional information to conventional MRI for evaluating and characterizing gliomas.

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Section: Discussionmentioning

confidence: 99%

Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patients

Lü

Pirzkall

et al. 2002

Magnetic Resonance Imaging

112

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“…Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC MRI) is an established technique in the evaluation of cerebral glial neoplasms. Relative cerebral blood volume (rCBV) measurements show reliable correlation with tumor grade and histopathologic findings of tumor neovascularity (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Perfusion data is most commonly analyzed using multiple small region-of-interest (ROI) measurements, an operator-dependent method.…”

mentioning

confidence: 99%

Comparison of region‐of‐interest analysis with three different histogram analysis methods in the determination of perfusion metrics in patients with brain gliomas

Young

Babb

Law

et al. 2007

Magnetic Resonance Imaging

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Purpose:To compare routine ROI analysis and three different histogram analyses in the grading of glial neoplasms. The hypothesis is that histogram methods can provide a robust and objective technique for quantifying perfusion data in brain gliomas. Current region-of-interest (ROI)-based methods for the analysis of dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC MRI) data are operator-dependent. Materials and Methods:A total of 92 patients underwent conventional and DSC MRI. Multiple histogram metrics were obtained for cerebral blood flow (CBF), cerebral blood volume (CBV), and relative CBV (rCBV) maps using tumoral (T), peritumoral (P), and total tumoral (TT) analysis. Results were compared to histopathologic grades. Statistical analysis included Mann-Whitney (MW) tests, Spearman rank correlation coefficients, logistic regression, and McNemar tests. Results:The maximum value of rCBV (rCBV max ) showed highly significant correlation with glioma grade (r ϭ 0.734, P Ͻ 0.001). The strongest histogram correlations (P Ͻ 0.0001) occurred with rCBV T SD (r ϭ 0.718), rCBV P SD 25 (r ϭ 0.724) and rCBV TT SD 50 (r ϭ 0.685). Multiple rCBV T , rCBV P , and rCBV TT histogram metrics showed significant correlations. CBF and CBV histogram metrics were less strongly correlated with glioma grade than rCBV histogram metrics. HISTOGRAM ANALYSIS is a quantitative technique used in a number of neuroimaging studies but is most commonly used in magnetization transfer ratio studies of patients with diffuse cerebral disease such as multiple sclerosis (1-4). Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC MRI) is an established technique in the evaluation of cerebral glial neoplasms. Relative cerebral blood volume (rCBV) measurements show reliable correlation with tumor grade and histopathologic findings of tumor neovascularity (5-16). Perfusion data is most commonly analyzed using multiple small region-of-interest (ROI) measurements, an operator-dependent method. ROI measurement of tumor rCBV has shown good reproducibility, but nevertheless remains operator-dependent and somewhat subjective, with an unavoidable component of interobserver and intraobserver variability. Reliable, reproducible data may only be obtained by experienced operators. Therefore, developing a more objective method that simplifies the analysis may allow even inexperienced operators to obtain reproducible data. Importantly, as surrogate imaging markers for angiogenesis are being investigated to determine the efficacy of antiangiogenic therapies (17), intra-and interinstitutional reproducibility becomes crucial, particularly when performing multicenter clinical trials using DSC MRI. The hypothesis is that histogram methods are comparable to, if not superior to current ROI-based methods for calculating the maximum value of rCBV (rCBV max ) in the prediction of glioma grade. We compare three methods of histogram analysis using both ROI- Conclusion

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“…Tü-mörlerin perfüzyon MRG özellikle-rini ortaya koymada en önemli parametre CBV haritalarından elde edilen rCBV oranıdır (15). rCBV haritaları ve ölçümleri tümör evrelendirmesinde faydalıdır ve artmış tümör vaskülaritesini güvenilir şekilde gösterir (2,8,11,16,(17)(18)(19)(20). CBV haritalamada gliyomların görünümü karmaşıktır.…”

Section: Discussionunclassified

Primer Beyin Tümörlerini Evrelendirmesinde Perfüzyon MRG’nin Katkısı

Horolsüren;ERDEN¹

2009

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Amaç: Primer malign lezyonlarda farklı histopatolojik tiplerdeki beyin tümörlerinde serebral kan hacminde (CBV) istatiksel açıdan anlamlı fark bulunup bulunmadığını saptamak. Ayrıca bu ölçüm-lerin tümör derecesi ile bağlantılı olup olmadığını da araştırdık. Gereç ve Yöntem:Bu çalışmaya primer beyin tümörü saptanan 25 hasta (20'si erkek, 5'i kadın) dahil edildi. MRG incelemeleri 1.5 T süperiletken magnet ile standart kafa sarmalı kullanılarak yapıldı. Tüm hastalara konvansiyonel MRG ve dinamik kontrastlı perfüzyon MRG aynı seansta yapıldı. Tespit edilen lezyon alanlarında rCBV oranları hesaplandı. rCBV oranını hesaplarken standart referans olarak kullanılmak üzere transaksiyel planda işaretlenen patolojik alanın karşı tarafında, aynı piksel sayısında alan işaretlenmiştir. Karşılaştırma amacı ile örnek alınan standart referans bölgeler; konvansiyonel T1A ve T2A kesitlerde normal sinyal özellikleri dikkate alınarak seçilmiştir. Bulgular: İncelenen tümörlerden 16'si yüksek evreli glial tümör (YEGT), 9'u düşük evreli glial tümör (DEGT) üdü. Tümöral rCBV ölçümlerine göre DEGT olguları ile YEGT (p<0.001) arasında istatiksel olarak anlamlı farklılık saptanmıştır.Sonuç: Perfüzyon MRG primer beyin tümörlerinin evrelemesinde konvansiyonel MRG bulguları ile birlikte yüksek doğrulukla kullanılabilmektedir. Anahtar Sözcükler: Beyin Tümörleri, Manyetik Rezonans Görüntüleme, Perfüzyon Ağırlıklı GörüntülemePurpose: To determine whether there are statistically differences in cerebral blood volume (CBV) of brain tumors of different histopathological types including primary malignant lesions. To determine whether these measurements relate to tumor grade. Materials and Methods:Our study included 25 patients (20 male, 5 female) who have primary intracranial tumors. MRI was performed in a 1.5 T, superconductive magnet with standart head coils. Conventional MRI and dynamic contrast-enhanced MRI were both performed at same time on all patients. rCBV ratios were calculated in and around the lesions detected while an area of the same pixel number and the opposite side of the pathologic area was pointed as a standart reference in the transaxial plane. Standart reference area chosen for a comparison had normal signal characteristics in the T1W and T2W images. Results:Sixteen of all tumors were high-grade glial tumors (HGGT), and nine were low-grade glial tumors (LGGT). Statistically meaningful differences were detected between HGGT and LGGT (p<0.001). Conclusion:Perfusion MRI can be used along with conventional MRI for a high accuracy grading of primary brain tumors.

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Correlation between dynamic MRI and outcome in patients with malignant gliomas

Cited by 38 publications

References 6 publications

Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patients

Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patients

Comparison of region‐of‐interest analysis with three different histogram analysis methods in the determination of perfusion metrics in patients with brain gliomas

Primer Beyin Tümörlerini Evrelendirmesinde Perfüzyon MRG’nin Katkısı

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