Glioma grading capability: comparisons among parameters from dynamic contrast-enhanced MRI and ADC value on DWI

Abstract

Objective: Permeability parameters from dynamic contrast-enhanced MRI (DCE-MRI) and apparent diffusion coefficient (ADC) value on diffusion-weighted imaging (DWI) can be quantitative physiologic metrics for gliomas. The transfer constant (K(trans)) has shown efficacy in grading gliomas. Volume fraction of extravascular extracellular space (ve) has been underutilized to grade gliomas. The purpose of this study was to evaluate ve in its ability to grade gliomas and to assess the correlation with other permeability parameters and ADC values.

Materials and methods: A total of 33 patients diagnosed with pathologically-confirmed gliomas were examined by 3 T MRI including DCE-MRI and ADC map. A region of interest analyses for permeability parameters from DCE-MRI and ADC were performed on the enhancing solid portion of the tumors. Permeability parameters form DCE-MRI and ADC between low- and high-grade gliomas; the diagnostic performances of presumptive metrics and correlation among those metrics were statistically analyzed.

Results: High-grade gliomas showed higher K(trans) (0.050 vs. 0.010 in median value, p = 0.002) and higher ve (0.170 vs. 0.015 in median value, p = 0.001) than low-grade gliomas. Receiver operating characteristic curve analysis showed significance in both K(trans) and ve for glioma grading. However, there was no significant difference in diagnostic performance between K(trans) and ve. ADC value did not correlate with any of the permeability parameters from DCE-MRI.

Conclusion: Extravascular extracellular space (ve) appears to be comparable with transfer constant (K(trans)) in differentiating high-grade gliomas from low-grade gliomas. ADC value does not show correlation with any permeability parameters from DCE-MRI.

Keywords: Apparent diffusion coefficient; Dynamic contrast-enhanced MRI; Glioma.

Fig. 1

Box plot of transfer constant (K^trans) between low- and high-grade gliomas. Low grade refers to gliomas of grades WHO 1 and 2; high grade refers to gliomas of grades WHO 3 and 4. WHO = World Health Organization

Fig. 2

Box plot of extravascular extracellular space (v_e) between low- and high-grade gliomas. Low grade refers to gliomas of grades WHO 1 and 2; high grade refers to gliomas of grades WHO 3 and 4. WHO = World Health Organization

Fig. 3

ROC curve of transfer constant (K^trans) and extravascular extracellular space (v_e) for differentiating high grade gliomas from low-grade gliomas. Dotted line is transfer constant (K^trans); solid line is extravascular extracellular space (v_e).

Fig. 4

Scatter plots for statistically significant variables. A. Transfer constant (K^trans) vs. extravascular extracellular space (v_e). B. Extravascular extracellular space (v_e) vs. plasma volume fraction (v_p).