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Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles.

作者信息

Pons-Escoda Albert, Garcia-Ruiz Alonso, Naval-Baudin Pablo, Martinez-Zalacain Ignacio, Castell Josep, Camins Angels, Vidal Noemi, Bruna Jordi, Cos Monica, Perez-Lopez Raquel, Oleaga Laura, Warnert Esther, Smits Marion, Majos Carles

机构信息

Radiology Department, Feixa Llarga SN, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain.

Neuro-oncology Unit, Feixa Llarga SN, Institut d'Investigació Biomèdica de Bellvitge- IDIBELL, 08907, Barcelona, Spain.

出版信息

Eur Radiol. 2024 Aug;34(8):5320-5330. doi: 10.1007/s00330-024-10611-z. Epub 2024 Jan 29.


DOI:10.1007/s00330-024-10611-z
PMID:38282078
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11255054/
Abstract

OBJECTIVE: Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. This research aims to provide a comprehensive understanding of each tumor's DSC-PWI signatures, evaluate the discriminative capacity of cerebral blood volume (CBV) and percentage of signal recovery (PSR) percentile values, and explore the synergy of CBV and PSR combination for pre-surgical differentiation. METHODS: Patients diagnosed with grade 2 and 3 IDH-mutant astrocytomas and IDH-mutant 1p19q-codeleted oligodendrogliomas were retrospectively retrieved (2010-2022). 3D segmentations of each tumor were conducted, and voxel-level CBV and PSR were extracted to compute mean, minimum, maximum, and percentile values. Statistical comparisons were performed using the Mann-Whitney U test and the area under the receiver operating characteristic curve (AUC-ROC). Lastly, the five most discriminative variables were combined for classification with internal cross-validation. RESULTS: The study enrolled 52 patients (mean age 45-year-old, 28 men): 28 astrocytomas and 24 oligodendrogliomas. Oligodendrogliomas exhibited higher CBV and lower PSR than astrocytomas across all metrics (e.g., mean CBV = 2.05 and 1.55, PSR = 0.68 and 0.81 respectively). The highest AUC-ROCs and the smallest p values originated from CBV and PSR percentiles (e.g., PSRp70 AUC-ROC = 0.84 and p value = 0.0005, CBVp75 AUC-ROC = 0.8 and p value = 0.0006). The mean, minimum, and maximum values yielded lower results. Combining the best five variables (PSRp65, CBVp70, PSRp60, CBVp75, and PSRp40) achieved a mean AUC-ROC of 0.87 for differentiation. CONCLUSIONS: Oligodendrogliomas exhibit higher CBV and lower PSR than astrocytomas, traits that are emphasized when considering percentiles rather than mean or extreme values. The combination of CBV and PSR percentiles results in promising classification outcomes. CLINICAL RELEVANCE STATEMENT: The combination of histogram-derived percentile values of cerebral blood volume and percentage of signal recovery from DSC-PWI enhances the presurgical differentiation between astrocytomas and oligodendrogliomas, suggesting that incorporating these metrics into clinical practice could be beneficial. KEY POINTS: • The unsupervised selection of percentile values for cerebral blood volume and percentage of signal recovery enhances presurgical differentiation of astrocytomas and oligodendrogliomas. • Oligodendrogliomas exhibit higher cerebral blood volume and lower percentage of signal recovery than astrocytomas. • Cerebral blood volume and percentage of signal recovery combined provide a broader perspective on tumor vasculature and yield promising results for this preoperative classification.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/70564b34cbef/330_2024_10611_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/69256946df0f/330_2024_10611_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/7116d2cb1298/330_2024_10611_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/10e31b361a05/330_2024_10611_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/4880cbb19792/330_2024_10611_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/70564b34cbef/330_2024_10611_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/69256946df0f/330_2024_10611_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/7116d2cb1298/330_2024_10611_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/10e31b361a05/330_2024_10611_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/4880cbb19792/330_2024_10611_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/11255054/70564b34cbef/330_2024_10611_Fig5_HTML.jpg

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本文引用的文献

[1]
A conditional inference tree model for predicting cancer risk of non-mass lesions detected on breast ultrasound.

Eur Radiol. 2024-7

[2]
"Everything Everywhere All at Once": Unraveling perfusion, permeability, and leakage effects in neurooncology with a single-dose, single-acquisition dual-echo DSC.

Eur Radiol. 2024-5

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Simultaneous quantification of perfusion, permeability, and leakage effects in brain gliomas using dynamic spin-and-gradient-echo echoplanar imaging MRI.

Eur Radiol. 2024-5

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The role of DSC MR perfusion in predicting IDH mutation and 1p19q codeletion status in gliomas: meta-analysis and technical considerations.

Neuroradiology. 2023-7

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J Magn Reson Imaging. 2023-6

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Radiomic features from dynamic susceptibility contrast perfusion-weighted imaging improve the three-class prediction of molecular subtypes in patients with adult diffuse gliomas.

Eur Radiol. 2023-5

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A multi-reader comparison of normal-appearing white matter normalization techniques for perfusion and diffusion MRI in brain tumors.

Neuroradiology. 2023-3

[8]
Diffuse Large B-Cell Epstein-Barr Virus-Positive Primary CNS Lymphoma in Non-AIDS Patients: High Diagnostic Accuracy of DSC Perfusion Metrics.

AJNR Am J Neuroradiol. 2022-11

[9]
Preoperative Diagnosis and Molecular Characterization of Gliomas With Liquid Biopsy and Radiogenomics.

Front Neurol. 2022-5-26

[10]
Grading of IDH-mutant astrocytoma using diffusion, susceptibility and perfusion-weighted imaging.

BMC Med Imaging. 2022-5-29

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