Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fujian, 350005, Fuzhou, China.
Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China.
Neuroradiology. 2023 Jun;65(6):1063-1071. doi: 10.1007/s00234-023-03145-6. Epub 2023 Apr 3.
An accurate assessment of the World Health Organization grade is vital for patients with pediatric gliomas to direct treatment planning. We aim to evaluate the diagnostic performance of whole-tumor histogram analysis of diffusion-weighted imaging (DWI) and dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) for differentiating pediatric high-grade gliomas from pediatric low-grade gliomas.
Sixty-eight pediatric patients (mean age, 10.47 ± 4.37 years; 42 boys) with histologically confirmed gliomas underwent preoperative MR examination. The conventional MRI features and whole-tumor histogram features extracted from apparent diffusion coefficient (ADC) and cerebral blood volume (CBV) maps were analyzed, respectively. Receiver operating characteristic curves and the binary logistic regression analysis were performed to determine the diagnostic performance of parameters.
For conventional MRI features, location, hemorrhage and tumor margin showed significant difference between pediatric high- and low-grade gliomas (all, P < .05). For advanced MRI parameters, ten histogram features of ADC and CBV showed significant differences between pediatric high- and low-grade gliomas (all, P < .05). The diagnostic performance of the combination of DSC-PWI and DWI (AUC = 0.976, sensitivity = 100%, NPV = 100%) is superior to conventional MRI or DWI model, respectively (AUC = 0.700, AUC = 0.830; both, P < .05).
The whole-tumor histogram analysis of DWI and DSC-PWI is a promising method for grading pediatric gliomas.
准确评估世界卫生组织分级对指导小儿脑胶质瘤患者的治疗计划至关重要。我们旨在评估弥散加权成像（DWI）和动态对比增强灌注加权成像（DSC-PWI）全肿瘤直方图分析对鉴别小儿高级别胶质瘤和小儿低级别胶质瘤的诊断性能。
68 例经组织学证实的脑胶质瘤患儿（平均年龄 10.47±4.37 岁，男 42 例）接受了术前磁共振检查。分别分析表观弥散系数（ADC）和脑血容量（CBV）图上的常规 MRI 特征和全肿瘤直方图特征。采用受试者工作特征曲线和二元逻辑回归分析来确定参数的诊断性能。
对于常规 MRI 特征，位置、出血和肿瘤边缘在小儿高级别和低级别胶质瘤之间有显著差异（均 P<0.05）。对于高级 MRI 参数，ADC 和 CBV 的十个直方图特征在小儿高级别和低级别胶质瘤之间有显著差异（均 P<0.05）。DSC-PWI 和 DWI 的联合（AUC=0.976，敏感性=100%，NPV=100%）的诊断性能优于常规 MRI 或 DWI 模型（AUC=0.700，AUC=0.830；均 P<0.05）。
DWI 和 DSC-PWI 的全肿瘤直方图分析是一种有前途的小儿脑胶质瘤分级方法。
