title: Variations of ITSS-Morphology and their Relationship to Location and Tumor Volume in Patients with Glioblastoma.
abstract: BACKGROUND
  Susceptibility weighted imaging and assessment of intratumoral susceptibility signal (ITSS) morphology is used to identify high-grade glioma (HGG) in patients with suspected brain neoplasm.
  
  
  OBJECTIVE
  The aim of this study was to outline variations in ITSS-morphology and their relationship to location as well as volume of the lesion in patients with glioblastoma (GB).
  
  
  METHODS
  Contrast-enhanced SWI (CE-SWI) images of 40 patients with histologically confirmed GB were analyzed retrospectively with particular attention to ITSS-morphology dividing all lesions into two groups. Considering the location of the lesion within brain parenchyma, lesions with and without involvement of the subventricular zone (SVZ+/SVZ-) were discerned. Additionally, the contrast-enhancing tumor volume was evaluated. Statistical analysis was based on a classification analysis resulting in a classification rule (tree) as well as Mann-Whitney-U test.
  
  
  RESULTS
  The distribution of ITSS-scores showed differences between the SVZ+ and SVZ- groups. While SVZ-GB showed only fine-linear or dot-like ITSS, in SVZ+ GB the ITSS-morphology changed with the tumor volume, that is, in larger tumors dense and conglomerated ITSS were the predominant finding.
  
  
  CONCLUSIONS
  Our findings indicate that ITSS-morphology is not a random phenomenon. Location of GB, as well as tumor volume, appear to be factors contributing to ITSS morphology.
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
authors.forename: Delia
authors.initials: D
authors.lastname: Fahrendorf
authors.affiliation: Department of Neuroradiology, Asklepios Clinic Nord-Heidberg, Hamburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Hesselmann
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.affiliation: Department of Neurosurgery, University Hospital Münster, Münster, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Wölfer
authors.affiliation: Institute of Neuropathology, University Hospital Münster, Münster, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Jeibmann
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kooijman
authors.affiliation: Philips Healthcare, Clinical Application, Lübeckertordamm, Hamburg, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Kugel
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.affiliation: Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital Basel.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden
keywords: Susceptibility weighted imaging; glioblastoma; intratumoral susceptibility; magnetic resonance imaging; signals