title: Utility of multiparametric 3-T MRI for glioma characterization.
abstract: BACKGROUND
  Accurate grading of cerebral glioma using conventional structural imaging techniques remains challenging due to the relatively poor sensitivity and specificity of these methods. The purpose of this study was to evaluate the relative sensitivity and specificity of structural magnetic resonance imaging and MR measurements of perfusion, diffusion, and whole-brain spectroscopic parameters for glioma grading.
  
  
  METHODS
  Fifty-six patients with radiologically suspected untreated glioma were studied with T1- and T2-weighted MR imaging, dynamic contrast-enhanced MR imaging, diffusion tensor imaging, and volumetric whole-brain MR spectroscopic imaging. Receiver-operating characteristic analysis was performed using the relative cerebral blood volume (rCBV), apparent diffusion coefficient, fractional anisotropy, and multiple spectroscopic parameters to determine optimum thresholds for tumor grading and to obtain the sensitivity, specificity, and positive and negative predictive values for identifying high-grade gliomas. Logistic regression was performed to analyze all the parameters together.
  
  
  RESULTS
  The rCBV individually classified glioma as low and high grade with a sensitivity and specificity of 100 and 88 %, respectively, based on a threshold value of 3.34. On combining all parameters under consideration, the classification was achieved with 2 % error and sensitivity and specificity of 100 and 96 %, respectively.
  
  
  CONCLUSIONS
  Individually, CBV measurement provides the greatest diagnostic performance for predicting glioma grade; however, the most accurate classification can be achieved by combining all of the imaging parameters.
authors: Department of Radiology & Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India 122002.
authors: Bhaswati
authors: B
authors: Roy
authors: Rakesh K
authors: RK
authors: Gupta
authors: Andrew A
authors: AA
authors: Maudsley
authors: Rishi
authors: R
authors: Awasthi
authors: Sulaiman
authors: S
authors: Sheriff
authors: Meng
authors: M
authors: Gu
authors: Nuzhat
authors: N
authors: Husain
authors: Sudipta
authors: S
authors: Mohakud
authors: Sanjay
authors: S
authors: Behari
authors: Chandra M
authors: CM
authors: Pandey
authors: Ram K S
authors: RK
authors: Rathore
authors: Daniel M
authors: DM
authors: Spielman
authors: Jeffry R
authors: JR
authors: Alger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001932:Brain Neoplasms / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
references: AJNR Am J Neuroradiol. 2004 May;25(5):746-55
references: 15140713
references: Neuro Oncol. 2011 Apr;13(4):447-55
references: 21297125
references: J Magn Reson Imaging. 2012 Jan;35(1):56-63
references: 22002882
references: Neuroradiology. 2006 Sep;48(9):622-31
references: 16752135
references: NMR Biomed. 2006 Jun;19(4):492-503
references: 16763967
references: J Comput Assist Tomogr. 2010 Jan;34(1):82-8
references: 20118727
references: AJNR Am J Neuroradiol. 2005 Nov-Dec;26(10):2466-74
references: 16286386
references: Magn Reson Med. 2009 Mar;61(3):548-59
references: 19111009
references: NMR Biomed. 2006 Jun;19(4):463-75
references: 16763973
references: J Magn Reson Imaging. 2012 Aug;36(2):468-75
references: 22535478
references: Neuroradiology. 2012 Mar;54(3):205-13
references: 21541688
references: Radiology. 1990 Feb;174(2):411-5
references: 2153310
references: J Magn Reson Imaging. 2007 Oct;26(4):871-80
references: 17896358
references: J Clin Neurosci. 2012 Jun;19(6):820-3
references: 22381582
references: AJR Am J Roentgenol. 2011 Jan;196(1):71-6
references: 21178049
references: Neuroradiology. 2002 May;44(5):371-81
references: 12012120
references: Neurol Res. 2009 Nov;31(9):931-9
references: 19215664
references: AJNR Am J Neuroradiol. 2006 Aug;27(7):1412-8
references: 16908549
references: Neuroradiology. 2004 Aug;46(8):619-27
references: 15243726
references: J Neurooncol. 1998 Nov;40(2):161-70
references: 9892098
references: AJNR Am J Neuroradiol. 2003 Nov-Dec;24(10):1989-98
references: 14625221
references: Radiology. 1999 Jun;211(3):791-8
references: 10352608