Jitender Saini1, Pradeep Kumar Gupta2, Prativa Sahoo3,4, Anup Singh5, Rana Patir6, Suneeta Ahlawat7, Manish Beniwal8, K Thennarasu9, Vani Santosh10, Rakesh Kumar Gupta11. 1. Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India. 2. Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, India. 3. Philips Health System, Philips India Limited, Bangalore, India. 4. Beckman Research Institute, Mathematical Oncology, bldg-74, Duarte, CA, USA. 5. Center for Biomedical Engineering, Indian Institute of Technology Delhi, Delhi, India. 6. Department of Neurosurgery, Fortis Memorial Research Institute, Gurugram, India. 7. SRL Diagnostics, Fortis Memorial Research Institute, Gurugram, India. 8. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. 9. Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India. 10. Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India. 11. Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, India. rakeshree1@gmail.com.
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.
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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