Dynamic Contrast‐Enhanced Perfusion MRI and Diffusion‐Weighted Imaging in Grading of Gliomas

Arévalo-Pérez, Julio; Peck, Kyung K.; Young, Robert J.; Holodny, Andrei I.; Karimi, Sasan; Lyo, John

doi:10.1111/jon.12239

Cited by 71 publications

(75 citation statements)

References 20 publications

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“…The Spearman test demonstrated that the K trans of tumours shows positive correlation with clinical stage. These were in concordance with many other studies on other tumours in vivo, such as breast cancer (26) and glioma (27).…”

Section: Discussionsupporting

confidence: 93%

Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0ï¿½T to assess early-stageï¿½nasopharyngeal carcinoma

Liu

2018

Oncol Lett

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Abstract. The present study aimed to assess early-stage nasopharyngeal carcinoma (NPC) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) at 3.0 T. A total of 44 patients newly diagnosed with NPC were included in the present study. All patients underwent MR examination at 3.0 T using DCE-MRI and DWI. The volume transfer constant (K trans ), flux rate constant between extravascular extracellular space and plasma (K ep ), the volume of extravascular extracellular space per unit volume of tissue (V e ) and the apparent diffusion coefficient (ADC) of tumours were investigated. Furthermore, the correlation between clinical stages and ADC value and K trans were analysed. The diagnostic accuracy of K trans and ADC were estimated using receiver operating characteristic curves. NPC stage correlated positively with K trans and negatively with ADC values. Additionally, tumour K trans negatively correlated with ADC value. The sensitivity and accuracy of combined K trans and ADC in distinguishing between stage II and stage III and stage III and IV were higher than the values of either measurement used separately. The present study suggested that K trans and ADC derived from DCE-MRI and DWI may be useful to detect stage early NPC accurately. K trans and ADC in combination were superior than either alone. IntroductionAmong head and neck cancers, nasopharyngeal carcinoma (NPC) has a distinct natural history, aetiology, histopathology, and epidemiology. Male and female incidence of approximately 3:1. Most patients diagnosed with NPC tend to present with stage III or IV disease as a result of its deep location and vague symptoms (1-3). Radiation therapy and chemoradiotherapy are the primary methods of treatment (4), and are administered according to the clinical stage (5), making early diagnosis and staging crucial.Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven useful in characterization of tumour microcirculation and microvascular density. It can delineate the tumour margin from the surrounding tissues (6). DCE-MRI was proved useful in field of differential diagnosis benign and malignant tumours, correlation with tumour grade and stage, early prediction response, and outcome to chemotherapy, radiotherapy and antiangiogenic therapy. Diffusion-weighted imaging (DWI) can indirectly reflect the cell density and microstructure of living tissue (7). Magnetic resonance imaging may be the most powerful and versatile modality in the field of oncology for staging, predicting of treatment response, and identifying disease relapse, particularly in head and neck cancer (8-13). Over-staging and under-staging are the drawbacks of both methods. Various previous studies on bladder and breast cancer demonstrated that the sensitivity and accuracy could be increased by using 15). To the best of our knowledge, no study has combined DCE-MRI and DWI together in the diagnosis and staging of early NPC patients. The purpose of the present study was to explore the feasibility...

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Section: Discussionsupporting

confidence: 93%

Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0ï¿½T to assess early-stageï¿½nasopharyngeal carcinoma

Liu

2018

Oncol Lett

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“…These two parameters have already been shown to be different between grade III and IV [12, 16], between HGGs and LGGs [12, 14–16, 50], and between grade II and III oligodendrogliomas [54]. In our study, k ep_90 was also significantly lower in grade IV gliomas.…”

Section: Discussionsupporting

confidence: 67%

Prognostic value of preoperative dynamic contrast-enhanced MRI perfusion parameters for high-grade glioma patients

et al. 2016

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IntroductionThe prognostic value of the dynamic contrast-enhanced (DCE) MRI perfusion and its histogram analysis-derived metrics is not well established for high-grade glioma (HGG) patients. The aim of this prospective study was to investigate DCE perfusion transfer coefficient (Ktrans), vascular plasma volume fraction (vp), extracellular volume fraction (ve), reverse transfer constant (kep), and initial area under gadolinium concentration time curve (IAUGC) as predictors of progression-free (PFS) and overall survival (OS) in HGG patients.MethodsSixty-nine patients with suspected anaplastic astrocytoma or glioblastoma underwent preoperative DCE-MRI scans. DCE perfusion whole tumor region histogram parameters, clinical details, and PFS and OS data were obtained. Univariate, multivariate, and Kaplan–Meier survival analyses were conducted. Receiver operating characteristic (ROC) curve analysis was employed to identify perfusion parameters with the best differentiation performance.ResultsOn univariate analysis, ve and skewness of vp had significant negative impacts, while kep had significant positive impact on OS (P < 0.05). ve was also a negative predictor of PFS (P < 0.05). Patients with lower ve and IAUGC had longer median PFS and OS on Kaplan–Meier analysis (P < 0.05). Ktrans and ve could also differentiate grade III from IV gliomas (area under the curve 0.819 and 0.791, respectively).ConclusionsHigh ve is a consistent predictor of worse PFS and OS in HGG glioma patients. vp skewness and kep are also predictive for OS. Ktrans and ve demonstrated the best diagnostic performance for differentiating grade III from IV gliomas.

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“…Vajapeyam et al [8] , in their recently published study, reported higher K trans and K ep values and lower V e values in higher-grade pediatric tumors. Our results differ from the results of previous DCE perfusion studies as we found no signifi-cant differences in the permeability measurements of low-and high-grade neoplasms [9,10,12,14] . However, when we compared the kinetic parameters of pilocytic astrocytomas with those of high-grade posterior fossa tumors like medulloblastoma, we found higher leakage and V e values in pilocytic tumors.…”

Section: Discussioncontrasting

confidence: 57%

“…Dynamic contrast-enhanced (DCE) perfusion is another exogenous contrast-based perfusion technique that has been used for the evaluation of brain tumors in adult patients [10][11][12] . There are a few DCE-based perfusion studies on tumor assessment in pediatric patients [8,13] .…”

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confidence: 99%

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Gupta¹,

Saini²,

Sahoo³

et al. 2017

Pediatr Neurosurg

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Background/Aims: Perfusion magnetic resonance imaging (MRI) is useful for preoperative assessment of brain tumors. Dynamic susceptibility contrast perfusion MRI is commonly used for evaluation of brain tumors. Dynamic contrast-enhanced (DCE) MRI is an alternative method that has mainly been used in adult brain tumors. In this preliminary study, we report our initial experience with the DCE perfusion MRI in pediatric brain tumors. Methods: Sixty-four newly diagnosed pediatric brain tumor patients underwent DCE perfusion MRI on a 3-T scanner. Hemodynamic and kinetic parametric maps were generated and the regions with the highest values were measured on each map. Statistical differences were sought to differentiate between low-grade tumors, high-grade tumors, and medulloblastomas. The perfusion metrics of common posterior fossa tumors were also compared. Results: Relative corrected cerebral blood volume (rCBV) and fractional plasma volume measures differed significantly between high- and low-grade tumors (p < 0.05). High-grade tumors could be differentiated from low-grade tumors, with an rCBV cutoff value of 2.41 and 88.6% sensitivity and 65% specificity. There was no significant difference in K^trans, K_ep, V_e, or λ^tr between these 2 groups of tumors. rCBV, relative quantification of the cerebral blood flow, and permeability indices were found to be significantly different in various posterior fossa tumors, i.e., pilocytic astrocytoma, ependymoma, and medulloblastoma (p < 0.05). Conclusion: DCE-derived perfusion metrics are useful in differentiating high-grade tumors from low-grade ones and discriminating among various posterior fossa tumors in the pediatric age group.

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Dynamic Contrast‐Enhanced Perfusion MRI and Diffusion‐Weighted Imaging in Grading of Gliomas

Cited by 71 publications

References 20 publications

Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0ï¿½T to assess early-stageï¿½nasopharyngeal carcinoma

Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0ï¿½T to assess early-stageï¿½nasopharyngeal carcinoma

Prognostic value of preoperative dynamic contrast-enhanced MRI perfusion parameters for high-grade glioma patients

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

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