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Differentiation of grade II/III and grade IV glioma by combining “T1 contrast-enhanced brain perfusion imaging” and susceptibility-weighted quantitative imaging

  • Diagnostic Neuroradiology
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Abstract

Purpose

MRI is a useful method for discriminating low- and high-grade glioma using perfusion MRI and susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of T1-perfusion MRI and SWI in discriminating among grade II, III, and IV gliomas.

Methods

T1-perfusion MRI was used to measure relative cerebral blood volume (rCBV) in 129 patients with glioma (70 grade IV, 33 grade III, and 26 grade II tumors). SWI was also used to measure the intratumoral susceptibility signal intensity (ITSS) scores for each tumor in these patients. rCBV and ITSS values were compared to seek differences between grade II vs. grade III, grade III vs. grade IV, and grade III+II vs. grade IV tumors.

Results

Significant differences in rCBV values of the three grades of the tumors were noted and pairwise comparisons showed significantly higher rCBV values in grade IV tumors as compared to grade III tumors, and similarly increased rCBV was seen in the grade III tumors as compared to grade II tumors (p < 0.001). Grade IV gliomas showed significantly higher ITSS scores on SWI as compared to grade III tumors (p < 0.001) whereas insignificant difference was seen on comparing ITSS scores of grade III with grade II tumors. Combining the rCBV and ITSS resulted in significant improvement in the discrimination of grade III from grade IV tumors.

Conclusion

The combination of rCBV values derived from T1-perfusion MRI and SWI derived ITSS scores improves the diagnostic accuracy for discrimination of grade III from grade IV gliomas.

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Author information

Author notes

  1. Prativa Sahoo

    Present address: Beckman Research Institute, Mathematical Oncology, bldg-74, Duarte, CA, USA

Authors and Affiliations

  1. Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India

    Jitender Saini

  2. Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, India

    Pradeep Kumar Gupta & Rakesh Kumar Gupta

  3. Philips Health System, Philips India Limited, Bangalore, India

    Prativa Sahoo

  4. Center for Biomedical Engineering, Indian Institute of Technology Delhi, Delhi, India

    Anup Singh

  5. Department of Neurosurgery, Fortis Memorial Research Institute, Gurugram, India

    Rana Patir

  6. SRL Diagnostics, Fortis Memorial Research Institute, Gurugram, India

    Suneeta Ahlawat

  7. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India

    Manish Beniwal

  8. Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India

    K. Thennarasu

  9. Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India

    Vani Santosh

Authors
  1. Jitender Saini
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  2. Pradeep Kumar Gupta
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  3. Prativa Sahoo
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  4. Anup Singh
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  5. Rana Patir
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  10. Rakesh Kumar Gupta
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Corresponding author

Correspondence to Rakesh Kumar Gupta.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

We declare that the study has been approved by the ethics committee of the Fortis Memorial Research Institute, Gurgaon, India, and National Institute of Mental Health and Neurosciences, Bangalore, India, and have therefore been performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Saini, J., Gupta, P.K., Sahoo, P. et al. Differentiation of grade II/III and grade IV glioma by combining “T1 contrast-enhanced brain perfusion imaging” and susceptibility-weighted quantitative imaging. Neuroradiology 60, 43–50 (2018). https://doi.org/10.1007/s00234-017-1942-8

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  • DOI: https://doi.org/10.1007/s00234-017-1942-8

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