Cornelia Brendle1, Johann-Martin Hempel2, Jens Schittenhelm3, Marco Skardelly4, Ghazaleh Tabatabai5, Benjamin Bender2, Ulrike Ernemann2, Uwe Klose2. 1. Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. cornelia.brendle@med.uni-tuebingen.de. 2. Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. 3. Neuropathology, Department of Pathology and Neuropathology, Eberhard Karls University, Calwerstr. 3, 72076, Tübingen, Germany. 4. University Department of Neurosurgery, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. 5. Interdisciplinary Section of Neurooncology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
Abstract
PURPOSE: To evaluate arterial spin labeling (ASL) perfusion and dynamic contrast-enhanced (DCE) perfusion in glioma grading according to the previous WHO classification of 2007, as well as concerning isocitrate dehydrogenase (IDH) mutation status and ATRX expression as required by the new WHO 2016 brain tumor classification. METHODS: The mean values of Ktrans, Kep, Ve, and Vp by DCE perfusion, and cerebral blood flow (CBF) by ASL perfusion were assessed retrospectively in 40 patients with initial glioma diagnosis. Perfusion parameters were correlated and compared concerning glioma grading, IDH mutation status and ATRX expression. RESULTS: The DCE and ASL perfusion parameters showed merely moderate correlation. The Ktrans, Ve, and CBF by DCE perfusion were different in low-grade and high-grade gliomas (p = 0.0018, p < 0.0001, and p = 0.0038, respectively). Ve was useful in distinguishing high-grade from low-grade gliomas (p = 0.024, sensitivity = 1.00, specificity = 0.80). CBF by ASL perfusion enabled discrimination of astrocytomas with and without IDH mutation (p = 0.014, sensitivity = 0.75, specificity = 0.88) and showed a trend for the discrimination of astrocytomas with IDH mutation from oligodendrogliomas (p = 0.074). CONCLUSION: In conclusion, DCE and ASL perfusion are complementary in the differentiation of gliomas. The discrimination of low- and high-grade gliomas is possible by the DCE perfusion parameter Ve, while ASL perfusion shows potential for the differentiation of the IDH and ATRX mutation status of gliomas following the new WHO classification 2016. Both perfusion techniques might represent different aspects of brain tumor perfusion.
PURPOSE: To evaluate arterial spin labeling (ASL) perfusion and dynamic contrast-enhanced (DCE) perfusion in glioma grading according to the previous WHO classification of 2007, as well as concerning isocitrate dehydrogenase (IDH) mutation status and ATRX expression as required by the new WHO 2016 brain tumor classification. METHODS: The mean values of Ktrans, Kep, Ve, and Vp by DCE perfusion, and cerebral blood flow (CBF) by ASL perfusion were assessed retrospectively in 40 patients with initial glioma diagnosis. Perfusion parameters were correlated and compared concerning glioma grading, IDH mutation status and ATRX expression. RESULTS: The DCE and ASL perfusion parameters showed merely moderate correlation. The Ktrans, Ve, and CBF by DCE perfusion were different in low-grade and high-grade gliomas (p = 0.0018, p < 0.0001, and p = 0.0038, respectively). Ve was useful in distinguishing high-grade from low-grade gliomas (p = 0.024, sensitivity = 1.00, specificity = 0.80). CBF by ASL perfusion enabled discrimination of astrocytomas with and without IDH mutation (p = 0.014, sensitivity = 0.75, specificity = 0.88) and showed a trend for the discrimination of astrocytomas with IDH mutation from oligodendrogliomas (p = 0.074). CONCLUSION: In conclusion, DCE and ASL perfusion are complementary in the differentiation of gliomas. The discrimination of low- and high-grade gliomas is possible by the DCE perfusion parameter Ve, while ASL perfusion shows potential for the differentiation of the IDH and ATRX mutation status of gliomas following the new WHO classification 2016. Both perfusion techniques might represent different aspects of brain tumor perfusion.
Entities:
Keywords:
Gene mutation; Glioma differentiation; MR perfusion; WHO 2007 CNS tumor classification; WHO 2016 CNS tumor classification
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