Prospective glioma grading using single-dose dynamic contrast-enhanced perfusion MRI

Jain, Krishan K.; Sahoo, Prativa; Tyagi, Rajeev K.; Mehta, Amol; Patir, Rana; Vaishya, Sandeep; Prakash, Neelesh; Vasudev, Naveen S.; Gupta, Rakesh K.

doi:10.1016/j.crad.2015.06.076

Cited by 34 publications

(34 citation statements)

References 30 publications

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“…For instance, perfusions parameters correlated well with KI 67 in glioma, when the data from high and low grade tumors were combined [24]. However, no significant correlation was observed in high or low grade tumors, when they were analyzed separately [24].…”

Section: Discussionmentioning

confidence: 90%

Correlations Between DCE MRI and Histopathological Parameters in Head and Neck Squamous Cell Carcinoma

Surov

Meyer

Gawlitza

et al. 2017

Translational Oncology

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BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) can characterize perfusion and vascularization of tissues. DCE MRI parameters can differentiate between malignant and benign lesions and predict tumor grading. The purpose of this study was to correlate DCE MRI findings and various histopathological parameters in head and neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS: Sixteen patients with histologically proven HNSCC (11 cases primary tumors and in 5 patients with local tumor recurrence) were included in the study. DCE imaging was performed in all cases and the following parameters were estimated: Ktrans, Ve, Kep, and iAUC. The tumor proliferation index was estimated on Ki 67 antigen stained specimens. Microvessel density parameters (stained vessel area, total vessel area, number of vessels, and mean vessel diameter) were estimated on CD31 antigen stained specimens. Spearman's non-parametric rank sum correlation coefficients were calculated between DCE and different histopathological parameters. RESULTS: The mean values of DCE perfusion parameters were as follows: Ktrans 0.189 ± 0.056 min−1, Kep 0.390 ± 0.160 min−1, Ve 0.548 ± 0.119%, and iAUC 22.40 ± 12.57. Significant correlations were observed between Kep and stained vessel areas (r = 0.51, P = .041) and total vessel areas (r = 0.5118, P = .043); between Ve and mean vessel diameter (r = −0.59, P = .017). Cell count had a tendency to correlate with Ve (r = −0.48, P = .058). In an analysis of the primary HNSCC only, a significant inverse correlation between Ktrans and KI 67 was identified (r = −0.62, P = .041). Our analysis showed significant correlations between DCE parameters and histopathological findings in HNSCC.

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Section: Discussionmentioning

confidence: 90%

Correlations Between DCE MRI and Histopathological Parameters in Head and Neck Squamous Cell Carcinoma

Surov

Meyer

Gawlitza

et al. 2017

Translational Oncology

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“…The majority of Grade I meningioma express VEGF and are highly vascular [21]. Therefore, there may not be a close correlation between increasing tumor grade and hyper-perfusion in meningioma (as exists, for example, in glioma [22]). In fact, the isoforms of VEGF expressed in higher grade meningioma (121 and 165) appear to induce vascularization patterns in mouse xenograft models that may have reduced or more variable blood flow [23] due to heterogeneous microvessel eruption, vessel dilation and hemorrhage [24].…”

Section: Discussionmentioning

confidence: 99%

Application of arterial spin labeling perfusion MRI to differentiate benign from malignant intracranial meningiomas

Qiao

Kim

Wang

et al. 2017

European Journal of Radiology

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Purpose: Differentiating WHO grade I–III of meningioma by non-invasive imaging is challenging. This study investigated the potential of MR arterial spin labeling (ASL) to establish tumor grade in meningioma patients. Material and methods: Pseudo-continuous ASL with 3D background suppressed gradient and spin echo (GRASE) was acquired on 54 patients with newly diagnosed or recurrent intracranial meningioma. Perfusion patterns characterized in CBF color maps were independently evaluated by three neuroradiologists blinded to patient history, and correlated with tumor grade from histo-pathological review. Results: Three perfusion patterns could be discerned by visual evaluation of CBF maps. Pattern 1 consisted of homogeneous hyper-perfusion of the entire tumor; pattern 2 demonstrated heterogeneous hyper-perfusion; pattern 3 showed no substantial hyper-perfusion. Evaluation of the perfusion patterns was highly concordant among the three readers (Kendall W = 0.9458, P < 0.0001). Pattern 1 was associated with WHO Grade I meningioma of (P < 0.0001). Patterns 2 and 3 were predictive of WHO Grade II and III meningioma (P < 0.0001), with an odds ratio (OR, versus pattern 1) of 49.6 (P < 0.01) in a univariate analysis, and an OR of 186.4 (P < 0.01) in a multivariate analysis. Conclusion: Qualitative evaluation of ASL CBF maps can help differentiate benign (WHO Grade I) from higher grade (WHO Grade II and III) intracranial meningiomas, potentially impacting therapeutic strategy.

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“…These parameters provide additional information about physiological tumor properties and could afford independent insight about clinical tumor behavior, especially as DCE perfusion parameters were shown not to correlate with DSC [10] or diffusion parameters [11] closely. DCE perfusion parameters have already been demonstrated to be diagnostic for glioma grade [12–17] and correlate with several proxies of hypoxia like microvascular density [18, 19] and HIF-1α and vascular endothelial growth factor (VEGF) expression [20]. DCE perfusion also has predictive value for treatment with neoangiogenesis inhibitors [21, 22] and chemoradiotherapy [23].…”

Section: Introductionmentioning

confidence: 99%

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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Prospective glioma grading using single-dose dynamic contrast-enhanced perfusion MRI

Cited by 34 publications

References 30 publications

Correlations Between DCE MRI and Histopathological Parameters in Head and Neck Squamous Cell Carcinoma

Correlations Between DCE MRI and Histopathological Parameters in Head and Neck Squamous Cell Carcinoma

Application of arterial spin labeling perfusion MRI to differentiate benign from malignant intracranial meningiomas

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

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