Relative percentage signal intensity recovery of perfusion metrics? An efficient tool for differentiating grades of glioma
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Date
2015-07
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BJR 2015;88.
Abstract
Objective: Glioma classification and characterization may
be facilitated by a multiparametric approach of perfusion
metrics, which could not be achieved by conventional
MRI alone. Our aim is to explore the potential of relative
percentage signal intensity recovery (rPSR) values, in
addition to relative cerebral blood volume (rCBV) and
relative cerebral blood flow (rCBF) of first-pass T2*
dynamic susceptibility contrast (DSC) perfusion MRI, in
differentiating high- and low-grade glioma.
Methods: This prospective study included 39 patients
with low-grade and 25 patients with high-grade
glioma. rPSR, rCBV and rCBF were calculated from
the first-pass T2* DSC perfusion MRI. rPSR was
calculated using standard software and validated with
dedicated perfusion metrics analysis software. The
statistical analysis was performed using analysis of
variance and receiver operating characteristic (ROC)
curves.
Results: Variation in rPSR, rCBV and rCBF values between
low- and high-grade gliomas were statistically
significant (p , 0.005). The ROC curve analysis for each
of them yielded 96% sensitivity and 71.8% specificity; 88%
sensitivity and 69.2% specificity; and 72% sensitivity and
66.7% specificity. The area under the curve (AUC) from
the ROC curve analysis yielded 0.893, 0.852 and 0.702 for
rPSR, rCBV and rCBF, respectively. The rPSR calculation
with the validation software yielded 92.3% sensitivity and
72% specificity with an AUC of 0.864.
Conclusion: rPSR inversely correlates while rCBV and
rCBF values directly correlate with the tumour grade.
Furthermore, the overall diagnostic performance of rPSR
is better than rCBV and rCBF values.
Advances in knowledge: rPSR of T2* DSC perfusion is an
indicator of blood–brain barrier status and lesion leakiness,
which has not been explored yet compared with the
usual haemodynamic parameters, rCBV and rCBF.
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Citation
Smitha KA, Gupta AK, Jayasree RS. Relative percentage signal intensity recovery of perfusion metrics? An efficient tool for differentiating grades of glioma. BJR 2015;88.