Perfusion Showdown: Comparison of Multiple MRI Perfusion Techniques in the Grading of Pediatric Brain Tumors.

Chang Y Ho, Nucharin Supakul, Greg Anthony, Qiuting Wen, Paula Chen, Maryann Allen, Jason G Parker, Benjamin R Gray, Eric Chen, Paul R Territo, Scott A Persohn, Stephen F Kralik, Gary D Hutchins
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引用次数: 0

Abstract

Background and purpose: There are multiple MRI perfusion techniques, with limited available literature comparing these techniques in the grading of pediatric brain tumors. For efficiency and limiting scan time, ideally only one MRI perfusion technique can be used in initial imaging. We compared DSC, dynamic contrast enhancement (DCE), and intravoxel incoherent motion (IVIM) along with ADC from DWI for differentiating high- versus low-grade pediatric brain tumors.

Materials and methods: Presurgical MRI at a single pediatric hospital for primary brain tumor of glial, neuronal, or embryonal origin including DWI, DSC, DCE, and IVIM with postsurgical histopathology results with World Health Organization (WHO) tumor grading were included. Tumor VOI was drawn on T2-weighted images registered to selected parametric maps from DWI, DSC, DCE, and IVIM. Multiple Bonferroni-corrected t tests were performed on the mean tumor values for each selected parameter, including histogram analysis of 95th percentile relative CBV (rCBV), 5th percentile ADC, and 5th percentile D, to evaluate for significance between high- and low-grade tumors. Receiver operating characteristic (ROC) analysis was performed for significant t test results.

Results: Seventy-two subjects were included with 36 low-grade and 36 high-grade tumors. t test after Bonferroni correction yielded significant results for 5th percentile ADC (P = .003), mean ADC (P = .006), mean D (P = .009), and 5th percentile D (P = .02). Specifically, 95th percentile rCBV, mean rCBV, D*, f, and all DCE parameters were not significant for high- versus low-grade pediatric brain tumors after correction. Only mean rCBV was significant before but not after Bonferroni correction (P = .04 → P = .35). ROC analysis for the parameters with t test significance before and after Bonferroni correction had the following AUC, in descending order: 5th percentile ADC (0.791, 0.68-0.88, P < .001), 5th percentile D (0.789, 0.68-0.88, P < .001), mean D (0.76, 0.64-0.85, P < .001), mean ADC (0.754,0.64-0.85, P < .001), and mean rCBV (0.683, 0.56-0.79, P = .004).

Conclusions: Perfusion parameters from IVIM, DCE, and DSC were not able to significantly differentiate between high- versus low-grade pediatric brain tumors compared with ADC in our study. Fifth percentile ADC performed the best and can be the primary technique for grading pediatric brain tumors.

灌注摊牌:多种MRI灌注技术在儿童脑肿瘤分级中的比较。
背景和目的:有多种MRI灌注技术,比较这些技术在儿童脑肿瘤分级中的可用文献有限。为了提高效率和限制扫描时间,理想情况下,初始成像只能使用一种MRI灌注技术。我们比较了DSC、DCE和IVIM以及DWI的ADC来区分高级别和低级别儿童脑肿瘤。材料和方法:纳入某儿科医院对神经胶质、神经元或胚胎源性原发性脑肿瘤的术前MRI检查,包括DWI、DSC、DCE和IVIM,以及术后组织病理学结果和WHO肿瘤分级。肿瘤VOI在T2加权图像上绘制,这些加权图像与DWI、DSC、DCE和IVIM的选定参数图配准。对每个选定参数的平均肿瘤值进行多次Bonferroni校正t检验,包括第95百分位rCBV、第5百分位ADC和第5百分位D的直方图分析,以评估高低级别肿瘤之间的显著性。对显著性t检验结果进行ROC分析。结果:纳入72例,低分级36例,高分级36例。经Bonferroni校正后的t检验对第5百分位ADC (p=0.003)、平均ADC (p=0.006)、平均D (p=0.009)和第5百分位D (p=0.02)均有显著性结果。具体而言,95百分位rCBV、平均rCBV、D*、f和所有DCE参数在矫正后的高分级和低分级儿童脑肿瘤中均无显著性差异。只有平均rCBV在Bonferroni校正前显著,而在Bonferroni校正后不显著(p=0.04→p=0.35)。对Bonferroni校正前后具有t检验显著性的参数进行ROC分析,AUC由高到低依次为:第5百分位ADC (0.791, 0.68-0.88, p)结论:在我们的研究中,与ADC相比,IVIM、DCE、DSC的灌注参数不能显著区分小儿脑肿瘤的高分级和低分级。第5百分位ADC表现最好,可作为儿童脑肿瘤分级的主要方法。缩写:ADC =表观扩散系数,DCE =动态对比度增强,DSC =动态敏感性伪影,DWI =扩散加权成像,IVIM =体素内非相干运动,VOI =感兴趣体素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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