Grading of cerebral glioma with multiparametric MR imaging and 18F-FDG-PET: concordance and accuracy.
OBJECTIVE
To retrospectively evaluate concordance rates and predictive values in concordant cases among multiparametric MR techniques and FDG-PET to grade cerebral gliomas.


METHODS
Multiparametric MR imaging and FDG-PET were performed in 60 consecutive patients with cerebral gliomas (12 low-grade and 48 high-grade gliomas). As the dichotomic variables, conventional MRI, minimum apparent diffusion coefficient in diffusion-weighted imaging, maximum relative cerebral blood volume ratio in perfusion-weighted imaging, choline/creatine ratio and (lipid and lactate)/creatine ratio in MR spectroscopy, and maximum standardised uptake value ratio in FDG-PET in low- and high-grade gliomas were compared. Their concordance rates and positive/negative predictive values (PPV/NPV) in concordant cases were obtained for the various combinations of multiparametric MR techniques and FDG-PET.


RESULTS
There were significant differences between low- and high-grade gliomas in all techniques. Combinations of two, three, four, and five out of the five techniques showed concordance rates of 77.0 ± 4.8%, 65.5 ± 4.0%, 58.3 ± 2.6% and 53.3%, PPV in high-grade concordant cases of 97.3 ± 1.7%, 99.1 ± 1.4%, 100.0 ± 0% and 100.0% and NPV in low-grade concordant cases of 70.2 ± 7.5%, 78.0 ± 6.0%, 80.3 ± 3.4% and 80.0%, respectively.


CONCLUSIONS
Multiparametric MR techniques and FDG-PET have a concordant tendency in a two-tiered classification for the grading of cerebral glioma. If at least two examinations concordantly indicated high-grade gliomas, the PPV was about 95%.


CONCLUSIONS
• Modern imaging techniques can help predict the aggressiveness of cerebral gliomas. • Multiparametric MRI and FDG-PET have a concordant tendency to grade cerebral gliomas. • Their high-grade concordant cases revealed at least 95 % positive predictive values. • Their low-grade concordant cases revealed about 70–80% negative predictive values.
Jeong Hee
JH
Yoon
Ji-hoon
JH
Kim
Won Jun
WJ
Kang
Chul-Ho
CH
Sohn
Seung Hong
SH
Choi
Tae Jin
TJ
Yun
Yong
Y
Eun
Yong Sub
YS
Song
Kee-Hyun
KH
Chang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18