The impact of diffusion and perfusion-weighted imaging on glioma grading

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-05-22 DOI:10.1515/oncologie-2024-0027

N. Dinh Hieu, N. Duy Hung, L. Thanh Dung, Nguyen Ngoc Anh, N. M. Minh Duc

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引用次数: 0

Abstract

Determining the grade of a glioma is extremely important for treatment planning and prognosis prediction. The study aimed to evaluate the usefulness of multiparametric perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) in preoperative glioma grading. In this retrospective study, 63 individuals with brain tumors histologically confirmed, of which 23 had low-grade gliomas (LGGs) and 40 had high-grade gliomas (HGGs) were involved. We conducted this paper on apparent diffusion coefficient (ADC) maps using the entire tumor volume method, allowing us to use all ADC values of the tumor. Small-sample regions of interest (ROIs) were drawn to collect parameters of relative cerebral blood flow (rCBF), cerebral blood flow (CBF), and relative cerebral blood volume (rCBV), from both the tumor core and peritumoral edema. The PWI and DWI metrics were compared to identify the most accurate distinguishing HGGs and LGGs, analyze receiver operating characteristics (ROC), and evaluate the diagnostic performance using solitary parameters and combined. In diffusion MRI, there were significant differences in minimum ADC and mean ADC between LGGs and HGGs (p<0.05), with the larger area under the curve (AUC) of 0.898 found for mean ADC at a cut-off value of 1.275, with sensitivity of 82.6 % and specificity of 90 %. The maximum ADC value did not differ significantly (p>0.05). All perfusion parameters in both the tumor core and peritumoral edema area were significantly greater values in cases of HGG compared to LGG (p<0.001), with the highest AUC of 0.946 found for solid tumor rCBV value (rCBVt), the cut-off is 3.585, sensitivity of 85 % and specificity of 100 %. Combining mean ADC and rCBVt provided an excellent AUC of 0.975, a sensitivity of 92.5 %, and a specificity of 91.3 % for differentiating between HGGs and LGGs. Perfusion and diffusion MRI are valuable in discriminating between high-grade and low-grade gliomas, with the major criterion in the decision-making process being the combined mean ADC and rCBVt parameters.

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弥散和灌注加权成像对胶质瘤分级的影响

确定胶质瘤的分级对治疗计划和预后预测极为重要。该研究旨在评估多参数灌注加权成像（PWI）和弥散加权成像（DWI）在胶质瘤术前分级中的作用。在这项回顾性研究中，有63名经组织学确诊的脑肿瘤患者，其中23人患有低级别胶质瘤（LGGs），40人患有高级别胶质瘤（HGGs）。我们采用整个肿瘤体积法对表观扩散系数（ADC）图进行了研究，从而可以使用肿瘤的所有 ADC 值。我们绘制了小样本感兴趣区（ROI），以收集肿瘤核心和瘤周水肿的相对脑血流（rCBF）、脑血流（CBF）和相对脑血容量（rCBV）参数。对 PWI 和 DWI 指标进行比较，以确定最能准确区分 HGG 和 LGG 的指标，分析接收器操作特征（ROC），并评估单独参数和组合参数的诊断性能。在弥散 MRI 中，LGGs 和 HGGs 的最小 ADC 和平均 ADC 存在显著差异（P0.05）。与LGG相比，HGG病例肿瘤核心和瘤周水肿区的所有灌注参数值均明显增大（P<0.001），其中实体瘤rCBV值（rCBVt）的AUC最高，为0.946，临界值为3.585，灵敏度为85%，特异度为100%。将平均 ADC 和 rCBVt 相结合，可获得极佳的 AUC 值（0.975），灵敏度为 92.5%，特异性为 91.3%，可用于区分 HGG 和 LGG。灌注和弥散 MRI 对区分高级别和低级别胶质瘤很有价值，决策过程中的主要标准是 ADC 和 rCBVt 的组合平均参数。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.