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. 2023 Jul 14;18(7):e0288412.
doi: 10.1371/journal.pone.0288412. eCollection 2023.

Dynamic susceptibility contrast perfusion-weighted and diffusion-weighted magnetic resonance imaging findings in pilocytic astrocytoma and H3.3 and H3.1 variant diffuse midline glioma, H3K27-altered

Ryo Kurokawa  1 , Mariko Kurokawa  1 , Akira Baba  1 , John Kim  1 , Ashok Srinivasan  1 , Toshio Moritani  1
Affiliations

Dynamic susceptibility contrast perfusion-weighted and diffusion-weighted magnetic resonance imaging findings in pilocytic astrocytoma and H3.3 and H3.1 variant diffuse midline glioma, H3K27-altered

Ryo Kurokawa et al. PLoS One. .

Abstract

Objective: This study compared the dynamic susceptibility contrast (DSC) magnetic resonance imaging parameters and apparent diffusion coefficient (ADC) between pilocytic astrocytoma (PA) and diffuse midline glioma, H3K27-altered (DMG) variants.

Methods: The normalized relative cerebral blood volume (nrCBV), normalized relative flow (nrCBF), percentile signal recovery (PSR), and normalized mean ADC (nADCmean) of 23 patients with midline PAs (median age, 13 years [range, 1-71 years]; 13 female patients) and 40 patients with DMG (8.5 years [1-35 years]; 19 female patients), including 35 patients with H3.3- and five patients with H3.1-mutant tumors, treated between January 2016 and May 2022 were statistically compared.

Results: DMG had a significantly lower nADCmean (median: 1.48 vs. 1.96; p = 0.00075) and lower PSR (0.97 vs. 1.23, p = 0.13) but higher nrCBV and nrCBF (1.66 vs. 1.17, p = 0.058, respectively, and 1.87 vs. 1.19, p = 0.028, respectively) than PA. The H3.3 variant had a lower nADCmean than the H3.1 variant (1.46 vs. 1.80, p = 0.10).

Conclusion: DMG had lower ADC and PSR and higher rCBV and rCBF than PA. The H3.3 variant had a lower ADC than the H3.1 variant. Recognizing the differences and similarities in the DSC parameters and ADC between these tumors may help presurgical diagnosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Pontine pilocytic astrocytoma in a 3-year-old boy.
The mass shows isointensity on diffusion-weighted imaging (a, arrow) and an increased apparent diffusion coefficient (nADCmean = 1.52) (b, arrow). The normalized relative cerebral blood volume and flow are 1.79 and 1.90, respectively (c and d, arrows). The corresponding post-contrast T1-weighted image and region-of-interest in this slice are shown (e). The percentage signal recovery of the mass is 1.50 (f). nADCmean = normalized mean apparent diffusion coefficient.
Fig 2
Fig 2. H3.3 variant diffuse midline glioma, H3K27-altered in a 28-year-old woman.
The mass shows hyperintensity on diffusion-weighted imaging (a, arrow) and a decreased apparent diffusion coefficient (nADCmean is 1.18) (b, arrow). The normalized relative cerebral blood volume and flow are 2.93 and 2.10, respectively (c and d, arrows). The corresponding post-contrast T1-weighted image and region-of-interest in this slice are shown (e). The percentage signal recovery of the mass is 0.63 (f). nADCmean = normalized mean apparent diffusion coefficient.
Fig 3
Fig 3. H3.1 variant diffuse midline glioma, H3K27-altered in a 4-year-old girl.
The mass shows isointensity on diffusion-weighted imaging (a, arrow) and an increased apparent diffusion coefficient (nADCmean = 1.72) (b, arrow). The normalized relative cerebral blood volume and flow are 1.76 and 1.56, respectively (c and d, arrows). The corresponding post-contrast T1-weighted image and region-of-interest in this slice are shown (e). The percentage signal recovery of the mass is 0.78 (f). nADCmean = normalized mean apparent diffusion coefficient.
See this image and copyright information in PMC

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