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. 2022 Jul 22:2022:5680522.
doi: 10.1155/2022/5680522. eCollection 2022.

The Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the Differentiation of Pseudoprogression and Recurrence of Intracranial Gliomas

Hui Jing  1   2 , Xuhong Yan  3 , Junjie Li  1 , Danlei Qin  1 , Ning Zhang  1 , Hui Zhang  1   4   5
Affiliations

The Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the Differentiation of Pseudoprogression and Recurrence of Intracranial Gliomas

Hui Jing et al. Contrast Media Mol Imaging. .

Abstract

Objective: The objective of this study was to determine the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing postoperative changes in intracranial gliomas.

Method: A total of fifty-one patients who had new enhanced lesions after surgical resection followed by standard radiotherapy and chemotherapy were collected retrospectively from October 2014 to June 2021. The patients were divided into a pseudoprogression group (15 cases) and a recurrence group (36 cases) according to the pathological results of the second operation or a follow-up of more than six months. The follow-up data of all patients were complete, and DCE-MRI was performed. The images were processed to obtain the quantitative parameters K trans, Ve, and Kep and the semiquantitative parameter iAUC, which were analysed with relevant statistical software.

Results: First, the difference in K trans and iAUC values between the two groups was statistically significant (P < 0.05), and the difference in Ve and Kep values was not statistically significant (P > 0.05). Second, by comparing the area under the curve, threshold, sensitivity and specificity of K trans, and iAUC, it was found that the iAUC threshold value was slightly higher than that of K trans, and the specificity of K trans was equal to that of iAUC, while the area under the curve and sensitivity of K trans were higher than those of iAUC. Third, K trans and iAUC had high accuracy in diagnosing recurrence and pseudoprogression, and K trans had higher accuracy than iAUC.

Conclusion: In this study, DCE-MRI has a certain diagnostic value in the early differentiation of recurrence and pseudoprogression, offering a new method for the diagnosis and assessment of gliomas after surgery.

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Conflict of interest statement

The authors declare that they have no conflicts of interests.

Figures

Figure 1
Figure 1
ROC curve of Ktrans and iAUC.
Figure 2
Figure 2
Histogram of the sensitivity and specificity of Ktrans and iAUC.
Figure 3
Figure 3
Histogram of the area under the ROC curve and threshold of Ktrans and iAUC.
Figure 4
Figure 4
Patient, female, 40 years old, left temporal glioma (WHO grade III). (a) The T1WI-CE scanning image before surgery; (b) a T2W1 scanning image 2 days after operation; (c) a T1W1-CE scanning image 2 days after operation; (d) the T2WI scanning image after 12 months of synchronous radiotherapy and chemotherapy; (e) the T1WI-CE scanning image after 12 months of synchronous radiotherapy and chemotherapy; (f) the Ktrans pseudo colour image after 12 months of synchronous radiotherapy and chemotherapy; (g) the iAUC pseudo colour image after 12 months of synchronous radiotherapy and chemotherapy; (h) the T1W1-CE scanning image after 25 months, diagnosed as pseudoprogression of the left temporal glioma.
Figure 5
Figure 5
Patient, male, 23 years old, left frontal glioblastoma (WHO grade IV). (a) The preoperative T1WI-CE scanning image; (b) the T2W1 scanning image 2 days after the operation; (c) the T1W1-CE scanning image 2 days after the operation; (d) the follow-up T2W1 scanning image 11 months after the synchronous radiotherapy and chemotherapy; (e) the follow-up T1WI-CE scanning image 11 months after the synchronous radiotherapy and chemotherapy; (f) the Ktrans pseudocolour image after 11 months of synchronous radiotherapy and chemotherapy; (g) the iAUC pseudocolour image 11 months after the synchronous radiotherapy and chemotherapy; (h) the histopathological results (HE ×400) of the second operation, confirming the recurrence of the left frontal glioma.
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