title: Dynamic Contrast-Enhanced Perfusion MRI and Diffusion-Weighted Imaging in Grading of Gliomas.
abstract: OBJECTIVE
  Accurate glioma grading is crucial for treatment planning and predicting prognosis. We performed a quantitative volumetric analysis to assess the diagnostic accuracy of histogram analysis of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) T1-weighted perfusion imaging in the preoperative evaluation of gliomas.
  
  
  METHODS
  Sixty-three consecutive patients with pathologically confirmed gliomas who underwent baseline DWI and DCE-MRI were enrolled. The patients were classified by histopathology according to tumor grade: 20 low-grade gliomas (grade II) and 43 high-grade gliomas (grades III and IV). Volumes-of-interest were calculated and transferred to DCE perfusion and apparent diffusion coefficient (ADC) maps. Histogram analysis was performed to determine mean and maximum values for Vp and Ktrans , and mean and minimum values for ADC. Comparisons between high-grade and low-grade gliomas, and between grades II, III, and IV, were performed. A Mann-Whitney U test at a significance level of corrected P ≤ .01 was used to assess differences.
  
  
  RESULTS
  All perfusion parameters could differentiate between high-grade and low-grade gliomas (P < .001) and between grades II and IV, grades II and III, and grades III and IV. Significant differences in minimum ADC were also found (P < .01). Mean ADC only differed significantly between high and low grades and grades II and IV (P < .01). There were no differences between grades II and III (P = .1) and grades III and IV (P = .71).
  
  
  CONCLUSIONS
  When derived from whole-tumor histogram analysis, DCE-MRI perfusion parameters performed better than ADC in noninvasively discriminating low- from high-grade gliomas.
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Julio
authors: J
authors: Arevalo-Perez
authors: Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Kyung K
authors: KK
authors: Peck
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Robert J
authors: RJ
authors: Young
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Andrei I
authors: AI
authors: Holodny
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Sasan
authors: S
authors: Karimi
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: John K
authors: JK
authors: Lyo
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D005910:Glioma / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: DCE-MRI; DW-MRI; glioma grading; histogram analysis