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

Clinical Neurology and Neurosurgery
Radwa K SolimanMostafa H Othman

Abstract

To assess the usefulness of intra-tumor and peri-tumoral relative cerebral blood volume (rCBV) in preoperative glioma grading. 21 patients with histopathologically 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). Multiple regions of interest (ROIs) have been drawn in the hotspots regions, the highest ROI has been selected to represent the rCBV of each intra-tumoral and peri-tumoral regions. Based on histopathology, tumors were subdivided into low grade and high grade. Receiver operating characteristic analysis (ROC) of rCBV, of both intra-tumoral and peri-tumoral regions, was performed to find cut-off values between high and low-grade tumors. The resulting sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Based on the histopathology, high-grade glioma (HGG) represented 76.2% whereas low-grade glioma (LGG) represented 23.8%. Both intra-tumoral and peri-tumoral rCBV of HGG were significantly higher than those of LGG. A cut-off value >2.9 for intra-tumoral rCBV provided sensitivity, specificity, and accuracy of 80%, 100%, and 85.7% res...Continue Reading

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