High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma

Nabavizadeh, Seyed Ali; Assadsangabi, Reza; Hajmomenian, Mehrdad; Santi, Mariarita; Vossough, Arastoo

doi:10.1007/s00234-015-1497-5

Cited by 16 publications

(3 citation statements)

References 30 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the relative tumor blood flow did not distinguish individual histology among posterior fossa tumors, relative tumor blood flow was significantly higher for medulloblastoma compared with pilocytic astrocytoma, with a cut-off value of the ratio of tumoral CBF to the brain parenchyma of 0.51, offering a sensitivity of 88% and specificity of 75% [ 103 ]. In a cohort of 24 patients, ASL was found to be highly accurate in distinguishing pilomyxoid astrocytoma, a WHO grade II tumor, from pilocytic astrocytoma, a WHO grade I tumor, with 77% sensitivity and 100% specificity using a threshold ratio value of 0.91 [ 104 ]. In the cohort of 17 patients reported by Gareton et al, pilocytic astrocytoma with anaplastic features (PAAF) depicted higher CBF values on ASL PWI as compared to classical PA and this finding was applicable to both posterior fossa PA with anaplasia and optic pathways PA with anaplasia.…”

Section: Mri Techniquesmentioning

confidence: 99%

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Nikam¹,

Yue²,

Kaur³

et al. 2022

Cancers

View full text Add to dashboard Cite

Central nervous system tumors are the most common pediatric solid tumors; they are also the most lethal. Unlike adults, childhood brain tumors are mostly primary in origin and differ in type, location and molecular signature. Tumor characteristics (incidence, location, and type) vary with age. Children present with a variety of symptoms, making early accurate diagnosis challenging. Neuroimaging is key in the initial diagnosis and monitoring of pediatric brain tumors. Conventional anatomic imaging approaches (computed tomography (CT) and magnetic resonance imaging (MRI)) are useful for tumor detection but have limited utility differentiating tumor types and grades. Advanced MRI techniques (diffusion-weighed imaging, diffusion tensor imaging, functional MRI, arterial spin labeling perfusion imaging, MR spectroscopy, and MR elastography) provide additional and improved structural and functional information. Combined with positron emission tomography (PET) and single-photon emission CT (SPECT), advanced techniques provide functional information on tumor metabolism and physiology through the use of radiotracer probes. Radiomics and radiogenomics offer promising insight into the prediction of tumor subtype, post-treatment response to treatment, and prognostication. In this paper, a brief review of pediatric brain cancers, by type, is provided with a comprehensive description of advanced imaging techniques including clinical applications that are currently utilized for the assessment and evaluation of pediatric brain tumors.

show abstract

Section: Mri Techniquesmentioning

confidence: 99%

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Nikam¹,

Yue²,

Kaur³

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…Three-tesla PASL has been used to differentiate haemangioblastomas and metastatic tumours, which are the major differential diagnoses of tumours in the posterior fossa in adults [ 149 ]. Recently, PASL showed high accuracy in distinguishing pilomyxoid astrocytomas (a relatively new WHO Classification addition) from pilocytic astrocytomas [ 150 ]. This type of differentiation is essential for making therapeutic decisions.…”

Section: Clinical Applicationsmentioning

confidence: 99%

A neuroradiologist’s guide to arterial spin labeling MRI in clinical practice

et al. 2015

View full text Add to dashboard Cite

Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood–brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies.

show abstract

“…Nevertheless, the relative values are considered more reliable than the absolute TBF values when distinguishing between HGGs and LGGs [7, 25] which has also been confirmed by our meta-analysis. Previous ASL tumour studies have used various normal brain regions for normalisation, including the GM [38] the WM [31], the mean of both [32], or the contralateral normal tissue mirrored to tumour [25]. Interestingly, the mirror ROI yielded better results than GM and WM as an internal standard [39], which is most likely due to the approximately similar distance from the labelling plane.…”

Section: Discussionmentioning

confidence: 99%

The value of arterial spin labelling in adults glioma grading: systematic review and meta-analysis

et al. 2019

View full text Add to dashboard Cite

This study aimed to evaluate the diagnostic performance of arterial spin labelling (ASL) in grading of adult gliomas. Eighteen studies matched the inclusion criteria and were included after systematic searches through EMBASE and MEDLINE databases. The quality of the included studies was assessed utilizing Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The quantitative values were extracted and a meta-analysis was subsequently based on a random-effect model with forest plot and joint sensitivity and specificity modelling. Hierarchical summary receiver operating characteristic (HROC) curve analysis was also conducted. The absolute tumour blood flow (TBF) values can differentiate high-grade gliomas (HGGs) from low-grade gliomas (LGGs) and grade II from grade IV tumours. However, it lacked the capacity to differentiate grade II from grade III tumours and grade III from grade IV tumours. In contrast, the relative TBF (rTBF) is effective in differentiating HGG from LGG and in glioma grading. The maximum rTBF (rTBFmax) demonstrated the best results in glioma grading. These results were also reflected in the sensitivity/specificity analysis in which the rTBFmax showed the highest discrimination performance in glioma grading. The estimated effect size for the rTBF was approximately similar between HGGs and LGGs, and grade II and grade III tumours, (–1.46 (–2.00, –0.91), p-value < 0.001), (–1.39 (–1.89, –0.89), p-value < 0.001), respectively; while it exhibited smaller effect size between grade III and grade IV (–1.05 (–1.82, –0.27)), p < 0.05). Sensitivity and specificity analysis replicate these results as well. This meta-analysis suggests that ASL is useful for glioma grading, especially when considering the rTBFmax parameter.

show abstract

High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma

Abstract: ASL imaging has high accuracy in differentiating PMA from PA. The result of this study may have important applications in prognostication and treatment planning especially in patients with less accessible tumors such as hypothalamic-chiasmatic gliomas.

Cited by 16 publications

References 30 publications

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

A neuroradiologist’s guide to arterial spin labeling MRI in clinical practice

The value of arterial spin labelling in adults glioma grading: systematic review and meta-analysis

Contact Info

Product

Resources

About