Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading: Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis

Corrado Santarosa, Antonella Castellano, Gian Marco Conte, Marcello Cadioli, Antonella Iadanza, M. R. Terreni, Alberto Franzin, Lorenzo Bello, Massimo Caulo, Andrea Falini, Nicoletta Anzalone

Research output: Contribution to journalArticle

Abstract

Introduction: Dynamic susceptibility contrast (DSC)-MRI is a perfusion technique with high diagnostic accuracy for glioma grading, despite limitations due to inherent susceptibility effects. Dynamic contrast-enhanced (DCE)-MRI has been proposed as an alternative technique able to overcome the DSC-MRI shortcomings. This pilot study aimed at comparing the diagnostic accuracy of DSC and DCE-MRI for glioma grading by evaluating two estimates of blood volume, the DCE-derived plasma volume (Vp) and the DSC-derived relative cerebral blood volume (rCBV), and a measure of vessel permeability, the DCE-derived volume transfer constant Ktrans. Methods: Twenty-six newly diagnosed glioma patients underwent 3T-MR DCE and DSC imaging. Parametric maps of CBV, Vp and Ktrans were calculated and the region of highest value (hotspot) was measured on each map. Histograms of rCBV, Vp and Ktrans values were calculated for the tumor volume. Statistical differences according to WHO grade were assessed. The diagnostic accuracy for tumor grading of the two techniques was determined by ROC analysis. Results: rCBV, Vp and Ktrans measures differed significantly between high and low-grade gliomas. Hotspot analysis showed the highest correlation with grading. Ktrans hotspots co-localized with Vp hotspots only in 56% of enhancing gliomas. For differentiating high from low-grade gliomas the AUC was 0.987 for rCBVmax, and 1.000 for Vpmax and Ktrans max. Combination of DCE-derived Vp and Ktrans parameters improved the diagnostic performance of the histogram method. Conclusion: This initial experience of DCE-derived Vp evaluation shows that this parameter is as accurate as the well-established DSC-derived rCBV for glioma grading. DCE-derived Ktrans is equally useful for grading, providing different informations with respect to Vp.

Original languageEnglish
Pages (from-to)1147-1156
Number of pages10
JournalEuropean Journal of Radiology
Volume85
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

Fingerprint

Perfusion Imaging
Glioma
Permeability
Neoplasm Grading
Plasma Volume
Blood Volume
Tumor Burden
ROC Curve
Area Under Curve
Perfusion
Cerebral Blood Volume

Keywords

  • Dynamic contrast-enhanced MRI
  • Dynamic susceptibility contrast
  • Glioma
  • Histogram analysis
  • MRI
  • Perfusion MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading : Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis. / Santarosa, Corrado; Castellano, Antonella; Conte, Gian Marco; Cadioli, Marcello; Iadanza, Antonella; Terreni, M. R.; Franzin, Alberto; Bello, Lorenzo; Caulo, Massimo; Falini, Andrea; Anzalone, Nicoletta.

In: European Journal of Radiology, Vol. 85, No. 6, 01.06.2016, p. 1147-1156.

Research output: Contribution to journalArticle

Santarosa, Corrado ; Castellano, Antonella ; Conte, Gian Marco ; Cadioli, Marcello ; Iadanza, Antonella ; Terreni, M. R. ; Franzin, Alberto ; Bello, Lorenzo ; Caulo, Massimo ; Falini, Andrea ; Anzalone, Nicoletta. / Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading : Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis. In: European Journal of Radiology. 2016 ; Vol. 85, No. 6. pp. 1147-1156.
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abstract = "Introduction: Dynamic susceptibility contrast (DSC)-MRI is a perfusion technique with high diagnostic accuracy for glioma grading, despite limitations due to inherent susceptibility effects. Dynamic contrast-enhanced (DCE)-MRI has been proposed as an alternative technique able to overcome the DSC-MRI shortcomings. This pilot study aimed at comparing the diagnostic accuracy of DSC and DCE-MRI for glioma grading by evaluating two estimates of blood volume, the DCE-derived plasma volume (Vp) and the DSC-derived relative cerebral blood volume (rCBV), and a measure of vessel permeability, the DCE-derived volume transfer constant Ktrans. Methods: Twenty-six newly diagnosed glioma patients underwent 3T-MR DCE and DSC imaging. Parametric maps of CBV, Vp and Ktrans were calculated and the region of highest value (hotspot) was measured on each map. Histograms of rCBV, Vp and Ktrans values were calculated for the tumor volume. Statistical differences according to WHO grade were assessed. The diagnostic accuracy for tumor grading of the two techniques was determined by ROC analysis. Results: rCBV, Vp and Ktrans measures differed significantly between high and low-grade gliomas. Hotspot analysis showed the highest correlation with grading. Ktrans hotspots co-localized with Vp hotspots only in 56{\%} of enhancing gliomas. For differentiating high from low-grade gliomas the AUC was 0.987 for rCBVmax, and 1.000 for Vpmax and Ktrans max. Combination of DCE-derived Vp and Ktrans parameters improved the diagnostic performance of the histogram method. Conclusion: This initial experience of DCE-derived Vp evaluation shows that this parameter is as accurate as the well-established DSC-derived rCBV for glioma grading. DCE-derived Ktrans is equally useful for grading, providing different informations with respect to Vp.",
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T1 - Dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging for glioma grading

T2 - Preliminary comparison of vessel compartment and permeability parameters using hotspot and histogram analysis

AU - Santarosa, Corrado

AU - Castellano, Antonella

AU - Conte, Gian Marco

AU - Cadioli, Marcello

AU - Iadanza, Antonella

AU - Terreni, M. R.

AU - Franzin, Alberto

AU - Bello, Lorenzo

AU - Caulo, Massimo

AU - Falini, Andrea

AU - Anzalone, Nicoletta

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Introduction: Dynamic susceptibility contrast (DSC)-MRI is a perfusion technique with high diagnostic accuracy for glioma grading, despite limitations due to inherent susceptibility effects. Dynamic contrast-enhanced (DCE)-MRI has been proposed as an alternative technique able to overcome the DSC-MRI shortcomings. This pilot study aimed at comparing the diagnostic accuracy of DSC and DCE-MRI for glioma grading by evaluating two estimates of blood volume, the DCE-derived plasma volume (Vp) and the DSC-derived relative cerebral blood volume (rCBV), and a measure of vessel permeability, the DCE-derived volume transfer constant Ktrans. Methods: Twenty-six newly diagnosed glioma patients underwent 3T-MR DCE and DSC imaging. Parametric maps of CBV, Vp and Ktrans were calculated and the region of highest value (hotspot) was measured on each map. Histograms of rCBV, Vp and Ktrans values were calculated for the tumor volume. Statistical differences according to WHO grade were assessed. The diagnostic accuracy for tumor grading of the two techniques was determined by ROC analysis. Results: rCBV, Vp and Ktrans measures differed significantly between high and low-grade gliomas. Hotspot analysis showed the highest correlation with grading. Ktrans hotspots co-localized with Vp hotspots only in 56% of enhancing gliomas. For differentiating high from low-grade gliomas the AUC was 0.987 for rCBVmax, and 1.000 for Vpmax and Ktrans max. Combination of DCE-derived Vp and Ktrans parameters improved the diagnostic performance of the histogram method. Conclusion: This initial experience of DCE-derived Vp evaluation shows that this parameter is as accurate as the well-established DSC-derived rCBV for glioma grading. DCE-derived Ktrans is equally useful for grading, providing different informations with respect to Vp.

AB - Introduction: Dynamic susceptibility contrast (DSC)-MRI is a perfusion technique with high diagnostic accuracy for glioma grading, despite limitations due to inherent susceptibility effects. Dynamic contrast-enhanced (DCE)-MRI has been proposed as an alternative technique able to overcome the DSC-MRI shortcomings. This pilot study aimed at comparing the diagnostic accuracy of DSC and DCE-MRI for glioma grading by evaluating two estimates of blood volume, the DCE-derived plasma volume (Vp) and the DSC-derived relative cerebral blood volume (rCBV), and a measure of vessel permeability, the DCE-derived volume transfer constant Ktrans. Methods: Twenty-six newly diagnosed glioma patients underwent 3T-MR DCE and DSC imaging. Parametric maps of CBV, Vp and Ktrans were calculated and the region of highest value (hotspot) was measured on each map. Histograms of rCBV, Vp and Ktrans values were calculated for the tumor volume. Statistical differences according to WHO grade were assessed. The diagnostic accuracy for tumor grading of the two techniques was determined by ROC analysis. Results: rCBV, Vp and Ktrans measures differed significantly between high and low-grade gliomas. Hotspot analysis showed the highest correlation with grading. Ktrans hotspots co-localized with Vp hotspots only in 56% of enhancing gliomas. For differentiating high from low-grade gliomas the AUC was 0.987 for rCBVmax, and 1.000 for Vpmax and Ktrans max. Combination of DCE-derived Vp and Ktrans parameters improved the diagnostic performance of the histogram method. Conclusion: This initial experience of DCE-derived Vp evaluation shows that this parameter is as accurate as the well-established DSC-derived rCBV for glioma grading. DCE-derived Ktrans is equally useful for grading, providing different informations with respect to Vp.

KW - Dynamic contrast-enhanced MRI

KW - Dynamic susceptibility contrast

KW - Glioma

KW - Histogram analysis

KW - MRI

KW - Perfusion MRI

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