Kazufumi Kikuchi1, Akio Hiwatashi2, Osamu Togao1, Koji Yamashita1, Ryotaro Kamei1, Mika Kitajima3, Masafumi Kanoto4, Hiroto Takahashi5, Yusuke Uchiyama6, Masafumi Harada7, Yuki Shinohara8, Takashi Yoshiura9, Yuki Wakata10, Hiroshi Honda1. 1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hiwatasi@radiol.med.kyushu-u.ac.jp. 3. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 4. Department of Radiology, Division of Diagnostic Radiology, Yamagata University Graduate School of Medical Science Medicine, Yamagata, Japan. 5. Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan. 6. Department of Radiology, Kurume University School of Medicine, Kurume, Japan. 7. Department of Radiology and Radiation Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. 8. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Tottori, Japan. 9. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. 10. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan.
Abstract
PURPOSE: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. METHODS: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor's solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P < .05 was considered to indicate significance. RESULTS: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P < .0001, P = .0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10-3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10-3 mm2/s) (P < .0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. CONCLUSION: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.
PURPOSE: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. METHODS: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor's solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P < .05 was considered to indicate significance. RESULTS: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P < .0001, P = .0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10-3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10-3 mm2/s) (P < .0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. CONCLUSION: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.
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