M Muge Karaman1, Yi Sui1,2, He Wang3, Richard L Magin2, Yuhua Li4, Xiaohong Joe Zhou5,6,7,8. 1. Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA. 2. Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA. 3. Philips Research China, Shanghai, China. 4. Xinhua Hospital, Shanghai, China. 5. Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA. xjzhou@uic.edu. 6. Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA. xjzhou@uic.edu. 7. Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA. xjzhou@uic.edu. 8. Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA. xjzhou@uic.edu.
Abstract
PURPOSE: To demonstrate that a continuous-time random-walk (CTRW) diffusion model can improve diagnostic accuracy of differentiating low- and high-grade pediatric brain tumors. METHODS: Fifty-four children with histopathologically confirmed brain tumors underwent diffusion MRI scans at 3Twith 12 b-values (0-4000 s/mm(2) ). The diffusion imageswere fit to a simplified CTRW model to extract anomalous diffusion coefficient, Dm , and temporal and spatial heterogeneity parameters, α and β, respectively. Using histopathology results as reference, a k-means clustering algorithm and a receiver operating characteristic (ROC) analysis were employed to determine the sensitivity, specificity, and diagnostic accuracy of the CTRW parameters in differentiating tumor grades. RESULTS: Significant differences between the low- and high-grade tumors were observed in the CTRW parameters (p-values<0.001). The k-means analysis showed that the combination of three CTRW parameters produced higher diagnostic accuracy (85% vs. 75%) and specificity (83% vs. 54%) than the apparent diffusion coefficient (ADC) from a mono-exponential model. The ROC analysis revealed that any combination of the CTRW parameters gave a larger area under the curve (0.90-0.96) than using ADC (0.80). CONCLUSION: With its sensitivity to intravoxel heterogeneity, the simplified CTRW model is useful for non-invasive grading of pediatric brain tumors, particularly when surgical biopsy is not feasible. Magn Reson Med 76:1149-1157, 2016.
PURPOSE: To demonstrate that a continuous-time random-walk (CTRW) diffusion model can improve diagnostic accuracy of differentiating low- and high-grade pediatric brain tumors. METHODS: Fifty-four children with histopathologically confirmed brain tumors underwent diffusion MRI scans at 3Twith 12 b-values (0-4000 s/mm(2) ). The diffusion imageswere fit to a simplified CTRW model to extract anomalous diffusion coefficient, Dm , and temporal and spatial heterogeneity parameters, α and β, respectively. Using histopathology results as reference, a k-means clustering algorithm and a receiver operating characteristic (ROC) analysis were employed to determine the sensitivity, specificity, and diagnostic accuracy of the CTRW parameters in differentiating tumor grades. RESULTS: Significant differences between the low- and high-grade tumors were observed in the CTRW parameters (p-values<0.001). The k-means analysis showed that the combination of three CTRW parameters produced higher diagnostic accuracy (85% vs. 75%) and specificity (83% vs. 54%) than the apparent diffusion coefficient (ADC) from a mono-exponential model. The ROC analysis revealed that any combination of the CTRW parameters gave a larger area under the curve (0.90-0.96) than using ADC (0.80). CONCLUSION: With its sensitivity to intravoxel heterogeneity, the simplified CTRW model is useful for non-invasive grading of pediatric brain tumors, particularly when surgical biopsy is not feasible. Magn Reson Med 76:1149-1157, 2016.
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