Ahmed Abdel Khalek Abdel Razek1, Lamiaa El-Serougy2, Mohamed Abdelsalam3, Gada Gaballa2, Mona Talaat2. 1. Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt. arazek@mans.edu.eg. 2. Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt. 3. Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Abstract
PURPOSE: The aim of this study is to differentiate recurrent/residual gliomas from postradiation changes using arterial spin labeling (ASL) perfusion and diffusion tensor imaging (DTI)-derived metrics. METHODS: Prospective study was conducted upon 42 patients with high-grade gliomas after radiotherapy only or prior to other therapies that underwent routine MR imaging, ASL, and DTI. The tumor blood flow (TBF), fractional anisotropy (FA), and mean diffusivity (MD) of the enhanced lesion and related edema were calculated. The lesion was categorized as recurrence/residual or postradiation changes. RESULTS: There was significant differences between residual/recurrent gliomas and postradiation changes of TBF (P = 0.001), FA (P = 0.001 and 0.04), and MD (P = 0.001) of enhanced lesion and related edema respectively. The area under the curve (AUC) of TBF of enhanced lesion and related edema used to differentiate residual/recurrent gliomas from postradiation changes were 0.95 and 0.93 and of MD were 0.95 and 0.81 and of FA were 0.81 and 0.695, respectively. Combined ASL and DTI metrics of the enhanced lesion revealed AUC of 0.98, accuracy of 95%, sensitivity of 93.8%, specificity of 95.8%, positive predictive value (PPV) of 93.8%, and negative predictive value (NPV) of 95.8%. Combined metrics of ASL and DTI of related edema revealed AUC of 0.97, accuracy of 92.5%, sensitivity of 93.8%, specificity of 91.7%, PPV of 88.2%, and NPV of 95.7. CONCLUSION: Combined ASL and DTI metrics of enhanced lesion and related edema are valuable noninvasive tools in differentiating residual/recurrent gliomas from postradiation changes.
PURPOSE: The aim of this study is to differentiate recurrent/residual gliomas from postradiation changes using arterial spin labeling (ASL) perfusion and diffusion tensor imaging (DTI)-derived metrics. METHODS: Prospective study was conducted upon 42 patients with high-grade gliomas after radiotherapy only or prior to other therapies that underwent routine MR imaging, ASL, and DTI. The tumor blood flow (TBF), fractional anisotropy (FA), and mean diffusivity (MD) of the enhanced lesion and related edema were calculated. The lesion was categorized as recurrence/residual or postradiation changes. RESULTS: There was significant differences between residual/recurrent gliomas and postradiation changes of TBF (P = 0.001), FA (P = 0.001 and 0.04), and MD (P = 0.001) of enhanced lesion and related edema respectively. The area under the curve (AUC) of TBF of enhanced lesion and related edema used to differentiate residual/recurrent gliomas from postradiation changes were 0.95 and 0.93 and of MD were 0.95 and 0.81 and of FA were 0.81 and 0.695, respectively. Combined ASL and DTI metrics of the enhanced lesion revealed AUC of 0.98, accuracy of 95%, sensitivity of 93.8%, specificity of 95.8%, positive predictive value (PPV) of 93.8%, and negative predictive value (NPV) of 95.8%. Combined metrics of ASL and DTI of related edema revealed AUC of 0.97, accuracy of 92.5%, sensitivity of 93.8%, specificity of 91.7%, PPV of 88.2%, and NPV of 95.7. CONCLUSION: Combined ASL and DTI metrics of enhanced lesion and related edema are valuable noninvasive tools in differentiating residual/recurrent gliomas from postradiation changes.
Authors: James R Fink; Robert B Carr; Eiji Matsusue; Ramesh S Iyer; Jason K Rockhill; David R Haynor; Kenneth R Maravilla Journal: J Magn Reson Imaging Date: 2011-10-14 Impact factor: 4.813
Authors: Fatima Tensaouti; Jonathan Khalifa; Amélie Lusque; Benjamin Plas; Jean Albert Lotterie; Isabelle Berry; Anne Laprie; Elizabeth Cohen-Jonathan Moyal; Vincent Lubrano Journal: Neuroradiology Date: 2017-08-25 Impact factor: 2.804
Authors: Tuva R Hope; Jonas Vardal; Atle Bjørnerud; Christopher Larsson; Marius R Arnesen; Raimo A Salo; Inge R Groote Journal: J Magn Reson Imaging Date: 2014-01-08 Impact factor: 4.813
Authors: Carrie M Carr; John C Benson; David R DeLone; Felix E Diehn; Dong Kun Kim; Kenneth W Merrell; Alex A Nagelschneider; Ajay A Madhavan; Derek R Johnson Journal: Neuroradiology Date: 2021-01-04 Impact factor: 2.804