Campos Lillian Gonçalves, de Oliveira Francine Hehn, Antunes Ápio Cláudio Martins, Duarte Juliana Ávila
Department of Radiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Radiol Bras. 2024 Sep 16;57:e20240025. doi: 10.1590/0100-3984.2024.0025. eCollection 2024 Jan-Dec.
OBJECTIVE: To determine the correlation of conventional and diffusion-weighted imaging findings on magnetic resonance imaging (MRI) of the brain, based on Visually AcceSAble Rembrandt Images (VASARI) criteria, with the histopathological grading of gliomas: low-grade or high-grade. MATERIALS AND METHODS: Preoperative MRI scans of 178 patients with brain gliomas and pathological confirmation were rated by two neuroradiologists for tumor size, location, and tumor morphology, using a standardized imaging feature set based on the VASARI criteria. RESULTS: In the univariate analysis, more than half of the MRI characteristics evaluated showed a significant association with the tumor grade. The characteristics most significantly associated with the tumor grade were hemorrhage; restricted diffusion; pial invasion; enhancement; and a non-contrast-enhancing tumor crossing the midline. In a multivariable regression model, the presence of enhancement and hemorrhage maintained a significant association with high tumor grade. The absence of contrast enhancement and restricted diffusion were associated with the presence of an isocitrate dehydrogenase gene mutation. CONCLUSION: Our data illustrate that VASARI MRI features, especially intratumoral hemorrhage, contrast enhancement, and multicentricity, correlate strongly with glial tumor grade.