Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
Neurosection, Division of MRI Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
J Neuroradiol. 2022 May;49(3):267-274. doi: 10.1016/j.neurad.2021.01.002. Epub 2021 Jan 19.
The aim of the study is to assess the diagnostic performance of inflow-based vascular-space-occupancy (iVASO) MR imaging for differentiating glioblastomas (grade IV, GBM) and lower-grade diffuse gliomas (grade II and III, LGG) and its potential to predict IDH mutation status.
One hundred and two patients with diffuse cerebral glioma (56 males; median age, 43.5 years) underwent iVASO and dynamic susceptibility contrast (DSC) MR imaging. The iVASO-derived arteriolar cerebral blood volume (CBVa), relative CBVa (rCBVa), and the DSC-derived relative cerebral blood volume (rCBV) were obtained, and these measurements were compared between the GBM group (n = 43) and the LGG group (n = 59) and between the IDH-mutation group (n = 54) and the IDH-wild group (n = 48).
Significant correlation was observed between rCBV and CBVa (P < 0.001) or rCBVa (P < 0.001). Both CBVa (P < 0.001) and rCBVa (P < 0.001) were higher in the GBM group. Both CBVa (P < 0.001) and rCBVa (P < 0.001) were lower in the IDH-mutation group compared to the IDH-wild group. Receiver operating characteristic analyses showed the area under curve (AUC) of 0.95 with CBVa and 0.97 with rCBVa in differentiating GBM from LGG. The AUCs were 0.82 and 0.85 for CBVa and rCBVa in predicting IDH gene status, respectively, which were lower than that of rCBV (AUC = 0.90). Combined rCBV and rCBVa significantly improved the diagnostic performance (AUC = 0.95).
iVASO MR imaging has the potential to predict IDH mutation and grade in glioma.
本研究旨在评估基于流入的血管空间占有率（iVASO）MR 成像在鉴别胶质母细胞瘤（IV 级，GBM）和低级别弥漫性胶质瘤（II 级和 III 级，LGG）方面的诊断性能，并评估其预测异柠檬酸脱氢酶（IDH）突变状态的潜力。
102 例弥漫性脑胶质瘤患者（56 例男性；中位年龄 43.5 岁）接受 iVASO 和动态磁敏感对比（DSC）MR 成像。获得 iVASO 衍生的毛细血管脑血容量（CBVa）、相对 CBVa（rCBVa）和 DSC 衍生的相对脑血容量（rCBV），并比较 GBM 组（n=43）和 LGG 组（n=59）以及 IDH 突变组（n=54）和 IDH 野生组（n=48）之间的这些测量值。
rCBV 与 CBVa（P<0.001）或 rCBVa（P<0.001）之间存在显著相关性。GBM 组的 CBVa（P<0.001）和 rCBVa（P<0.001）均较高。与 IDH 野生组相比，IDH 突变组的 CBVa（P<0.001）和 rCBVa（P<0.001）均较低。受试者工作特征曲线分析显示，CBVa 的曲线下面积（AUC）为 0.95，rCBVa 的 AUC 为 0.97，可用于鉴别 GBM 与 LGG。CBVa 和 rCBVa 预测 IDH 基因状态的 AUC 分别为 0.82 和 0.85，均低于 rCBV（AUC=0.90）。rCBV 和 rCBVa 的联合应用显著提高了诊断性能（AUC=0.95）。
iVASO MR 成像有可能预测胶质瘤的 IDH 突变和分级。
