title: Benefits of contrast-enhanced SWI in patients with glioblastoma multiforme.
abstract: BACKGROUND
  SWI can help to identify high-grade gliomas (HGG). The objective of this study was to analyse SWI and CE-SWI characteristics, i.e. the relationship between contrast-induced phase shifts (CIPS) and intratumoral susceptibility signals (ITSS) and their association with tumour volume in patients with glioblastoma multiforme (GBM).
  
  
  METHODS
  MRI studies of 29 patients were performed to evaluate distinct susceptibility signals comparing SWI and CE-SWI characteristics. The relationship between these susceptibility signals and CE-T1w tumour volume was analysed by using Spearman's rank correlation coefficient and Kruskal-Wallis-test. Tumour biopsies of different susceptibility signals were performed in one patient.
  
  
  RESULTS
  Comparison of SWI and CE-SWI demonstrated different susceptibility signals. Susceptibility signals visible on SWI images are consistent with ITSS; those only seen on CE-SWI were identified as CIPS. Correlation with CE-T1w tumour volume revealed that CIPS were especially present in small or medium-sized GBM (Spearman's rho r = 0.843, P < 0.001). Histology identified the area with CIPS as the tumour invasion zone, while the area with ITSS represented micro-haemorrhage, highly pathological vessels and necrosis.
  
  
  CONCLUSIONS
  CE-SWI adds information to the evaluation of GBM before therapy. It might have the potential to non-invasively identify the tumour invasion zone as demonstrated by biopsies in one case.
  
  
  CONCLUSIONS
  • MRI is used to help differentiate between low- and high-grade gliomas. • Contrast-enhanced susceptibility-weighted MRI (CE-SWI) helps to identify patients with glioblastoma multiforme. • CE-SWI delineates the susceptibility signal (CIPS and ITSS) more than the native SWI. • CE-SWI might have the potential to non-invasively identify the tumour invasion zone.
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany, deliamarie.fahrendorf@ukmuenster.de.
authors.forename: Delia
authors.initials: D
authors.lastname: Fahrendorf
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.forename: Johannes
authors.initials: J
authors.lastname: Wölfer
authors.forename: Astrid
authors.initials: A
authors.lastname: Jeibmann
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kooijman
authors.forename: Harald
authors.initials: H
authors.lastname: Kugel
authors.forename: Oliver
authors.initials: O
authors.lastname: Grauer
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.forename: Volker
authors.initials: V
authors.lastname: Hesselmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Bink
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005909:Glioblastoma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
references.citation: Magn Reson Imaging Clin N Am. 2009 Feb;17(1):47-61
references.pmid: 19364599
references.citation: Neoplasia. 2011 Sep;13(9):784-91
references.pmid: 21969812
references.citation: J Neurooncol. 2010 Dec;100(3):489-90
references.pmid: 20449628
references.citation: Eur J Radiol. 2012 Feb;81(2):272-6
references.pmid: 21216124
references.citation: Invest Radiol. 2003 Jul;38(7):409-14
references.pmid: 12821854
references.citation: AJNR Am J Neuroradiol. 2009 Sep;30(8):1574-9
references.pmid: 19461062
references.citation: J Magn Reson Imaging. 2006 Jul;24(1):41-51
references.pmid: 16755540
references.citation: Z Med Phys. 2006;16(4):240-50
references.pmid: 17216749
references.citation: AJNR Am J Neuroradiol. 2009 Jan;30(1):19-30
references.pmid: 19039041
references.citation: AJNR Am J Neuroradiol. 2009 Feb;30(2):232-52
references.pmid: 19131406
references.citation: AJNR Am J Neuroradiol. 2010 Jun;31(6):1049-54
references.pmid: 20110377
references.citation: Neuro Oncol. 2008 Dec;10(6):1025-34
references.pmid: 18667747
references.citation: Chin Med J (Engl). 2008 Oct 20;121(20):2021-5
references.pmid: 19080268
references.citation: J Magn Reson Imaging. 2009 Jan;29(1):177-82
references.pmid: 19097156
references.citation: Int J Radiat Oncol Biol Phys. 2012 Mar 1;82(3):e493-500
references.pmid: 22000750
references.citation: Oncogene. 1999 Sep 20;18(38):5356-62
references.pmid: 10498889
references.citation: AJNR Am J Neuroradiol. 2007 Aug;28(7):1280-6
references.pmid: 17698528
references.citation: J Magn Reson Imaging. 2005 Oct;22(4):439-50
references.pmid: 16163700
references.citation: Magn Reson Med. 1993 Dec;30(6):764-8
references.pmid: 8139461
references.citation: AJNR Am J Neuroradiol. 2009 Aug;30(7):1402-8
references.pmid: 19369602
references.citation: Magn Reson Med. 2004 Sep;52(3):612-8
references.pmid: 15334582
references.citation: J Neuroimaging. 2012 Apr;22(2):155-9
references.pmid: 21447023
references.citation: J Neurosurg. 1961 Sep;18:636-44
references.pmid: 13768222
references.citation: AJNR Am J Neuroradiol. 2007 Feb;28(2):316-7
references.pmid: 17297004
references.citation: Eur J Radiol. 2010 Jul;75(1):e81-5
references.pmid: 19726149
references.citation: Jpn J Radiol. 2010 May;28(4):299-304
references.pmid: 20512548
references.citation: Science. 1999 Jun 18;284(5422):1994-8
references.pmid: 10373119