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Preoperative Grading of Glioma Using Dynamic Susceptibility Contrast MRI: relative Cerebral Blood Volume Analysis of Intra-tumoral and Peri-tumoral Tissue

مؤلف البحث
رضوى كامل عبدالناصر, ساره على جمال,عبدالحكيم عبدالستار,مصطفى هاشم عثمان
مجلة البحث
American Society of Neruoradiology ASNR مؤتمر الأشعة الخاص بالجمعية
المشارك في البحث
الناشر
NULL
تصنيف البحث
3
عدد البحث
NULL
موقع البحث
NULL
سنة البحث
2017
صفحات البحث
NULL
ملخص البحث

Methods: 21 patients with histopathological confirmed glioma were included. Imaging was achieved on a 1.5T MRI scanner. Dynamic susceptibility contrast (DSC) MRI was performed using T2* weighted gradient echo-planner imaging (EPI). A series of 50 dynamic scans were acquired at 1.9 seconds intervals after intravenous bolus injection of 10 mmol/kg Gd- DTPA. Multiple ROIs have been drawn in the hot spots of both intra-tumoral and peri-tumoral regions, corresponding the colour maps. The highest ROI has been selected to represent the rCBV of each intra-tumoral and peri-tumoral regions. Tumors were subdivided into low grades and high grade on the basis of histopathology. Receiver operating characteristic analysis of rCBV, of both intra-tumoral and peri-tumoral regions, was performed to find cutoff values between high and low grade tumors. The resulting sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.

Results: Based on the histopathology, high grade glioma (HGG) represented 71.4% whereas low grade glioma (LGG) represented 28.8%. Both intra-tumoral and peri-tumoral rCBV of HGG were significantly higher than those of LGG. The cut-off value = 2.9 for intratumoral rCBV provided sensitivity, specificity, positive predictive values, negative predictive values, and accuracy of 80%, 100%, 100%, 66.7% and 85.7% respectively to differentiate between HGG and LGG. Additionally, the cut-off value = 0.7 for peri-tumoral rCBV provided sensitivity, specificity, positive predictive values, negative predictive values, and accuracy of 100%, 66.6%, 88.2%, 100%, and 90.5% respectively to differentiate between HGG and LGG.

Conclusion: ROI of the highest rCBV is significantly reliable for the preoperative distinction between HGG and LGG. Combined intra-tumoral and peri-tumoral rCBV provides overall better diagnostic accuracy and helps to decrease the invasive intervention for non-surgical candidates.