Karoline Skogen1, Anselm Schulz2, Johann Baptist Dormagen2, Balaji Ganeshan3, Eirik Helseth4, Andrès Server5. 1. Oslo University Hospitals, Ullevål Sykehus, Department of Radiology and Nuclear Medicine, Oslo, Norway. Electronic address: kaskog@ous-hf.no. 2. Oslo University Hospitals, Ullevål Sykehus, Department of Radiology and Nuclear Medicine, Oslo, Norway. 3. University College London, Department of Nuclear Medicine, United Kingdom. 4. Oslo University Hospitals, Ullevål Sykehus, Department of Neurosurgery, Oslo, Norway; University of Oslo, Department of Medicine, Oslo, Norway. 5. Oslo University Hospitals, Rikshospitalet, Department of Radiology and Nuclear Medicine, Oslo, Norway.
Abstract
BACKGROUND AND PURPOSE: Grading of cerebral gliomas is important both in treatment decision and assessment of prognosis. The purpose of this study was to determine the diagnostic accuracy of grading cerebral gliomas by assessing the tumor heterogeneity using MRI texture analysis (MRTA). MATERIAL AND METHODS: 95 patients with gliomas were included, 27 low grade gliomas (LGG) all grade II and 68 high grade gliomas (HGG) (grade III=34 and grade IV=34). Preoperative MRI examinations were performed using a 3T scanner and MRTA was done on preoperative contrast-enhanced three-dimensional isotropic spoiled gradient echo images in a representative ROI. The MRTA was assessed using a commercially available research software program (TexRAD) that applies a filtration-histogram technique for characterizing tumor heterogeneity. Filtration step selectively filters and extracts texture features at different anatomical scales varying from 2mm (fine features) to 6mm (coarse features), the statistical parameter standard deviation (SD) was obtained. Receiver operating characteristics (ROC) was performed to assess sensitivity and specificity for differentiating between the different grades and calculating a threshold value to quantify the heterogeneity. RESULTS: LGG and HGG was best discriminated using SD at fine texture scale, with a sensitivity and specificity of 93% and 81% (AUC 0.910, p<0.0001). The diagnostic ability for MRTA to differentiate between the different sub-groups (grade II-IV) was slightly lower but still significant. CONCLUSIONS: Measuring heterogeneity in gliomas to discriminate HGG from LGG and between different histological sub-types on already obtained images using MRTA can be a useful tool to augment the diagnostic accuracy in grading cerebral gliomas and potentially hasten treatment decision.
BACKGROUND AND PURPOSE: Grading of cerebral gliomas is important both in treatment decision and assessment of prognosis. The purpose of this study was to determine the diagnostic accuracy of grading cerebral gliomas by assessing the tumor heterogeneity using MRI texture analysis (MRTA). MATERIAL AND METHODS: 95 patients with gliomas were included, 27 low grade gliomas (LGG) all grade II and 68 high grade gliomas (HGG) (grade III=34 and grade IV=34). Preoperative MRI examinations were performed using a 3T scanner and MRTA was done on preoperative contrast-enhanced three-dimensional isotropic spoiled gradient echo images in a representative ROI. The MRTA was assessed using a commercially available research software program (TexRAD) that applies a filtration-histogram technique for characterizing tumor heterogeneity. Filtration step selectively filters and extracts texture features at different anatomical scales varying from 2mm (fine features) to 6mm (coarse features), the statistical parameter standard deviation (SD) was obtained. Receiver operating characteristics (ROC) was performed to assess sensitivity and specificity for differentiating between the different grades and calculating a threshold value to quantify the heterogeneity. RESULTS: LGG and HGG was best discriminated using SD at fine texture scale, with a sensitivity and specificity of 93% and 81% (AUC 0.910, p<0.0001). The diagnostic ability for MRTA to differentiate between the different sub-groups (grade II-IV) was slightly lower but still significant. CONCLUSIONS: Measuring heterogeneity in gliomas to discriminate HGG from LGG and between different histological sub-types on already obtained images using MRTA can be a useful tool to augment the diagnostic accuracy in grading cerebral gliomas and potentially hasten treatment decision.
Authors: Madison R Hansen; Edward Pan; Andrew Wilson; Morgan McCreary; Yeqi Wang; Thomas Stanley; Marco C Pinho; Xiaohu Guo; Darin T Okuda Journal: J Neurooncol Date: 2018-06-07 Impact factor: 4.130
Authors: Ben Shofty; Moran Artzi; Dafna Ben Bashat; Gilad Liberman; Oz Haim; Alon Kashanian; Felix Bokstein; Deborah T Blumenthal; Zvi Ram; Tal Shahar Journal: Int J Comput Assist Radiol Surg Date: 2017-12-21 Impact factor: 2.924
Authors: V Giannini; S Mazzetti; I Bertotto; C Chiarenza; S Cauda; E Delmastro; C Bracco; A Di Dia; F Leone; E Medico; A Pisacane; D Ribero; M Stasi; D Regge Journal: Eur J Nucl Med Mol Imaging Date: 2019-01-13 Impact factor: 9.236