title: Glioma grading by microvascular permeability parameters derived from dynamic contrast-enhanced MRI and intratumoral susceptibility signal on susceptibility weighted imaging.
abstract: BACKGROUND
  Dynamic contrast-enhanced MRI (DCE-MRI) estimates vascular permeability of brain tumors, and susceptibility-weighted imaging (SWI) may demonstrate tumor vascularity by intratumoral susceptibility signals (ITSS). This study assessed volume transfer constant (Ktrans) accuracy, the volume of extravascular extracellular space (EES) per unit volume of tissue (Ve) derived from DCE-MRI, and the degree of ITSS in glioma grading.
  
  
  METHODS
  Thirty-two patients with different glioma grades were enrolled in this retrospective study. Patients underwent DCE-MRI and non-contrast enhanced SWI by three-tesla scanning. Ktrans values, Ve, and the degree of ITSS in glioma were compared. Receiver operating characteristic (ROC) curve analysis determined diagnostic performances of Ktrans and Ve in glioma grading, and Spearman's correlation analysis determined the associations between Ktrans, Ve, ITSS, and tumor grade.
  
  
  RESULTS
  Ktrans and Ve values were significantly different between low grade gliomas (LGGs) and both high grade gliomas (HGGs) and grade II, III and IV gliomas (P<0.01). The degree of ITSS of LGGs was lower than HGGs (P<0.01), and the ITSS of grade II gliomas was lower than grade III or IV gliomas. Ktrans and Ve were correlated with glioma grade (P<0.01), while ITSS was moderately correlated (P<0.01). Ktrans values were moderately correlated with ITSS in the same segments (P<0.01).
  
  
  CONCLUSIONS
  Ktrans and Ve values, and ITSS helped distinguish the differences between LGGs and HGGs and between grade II, III and IV gliomas. There was a moderate correlation between Ktrans and ITSS in the same tumor segments.
authors.affiliation: Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. lixiaoguang0708@qq.com.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiology, Tianchang people's hospital, Tianchang, Anhui, 239300, China. 407727750@qq.com.
authors.forename: Yongshan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. kanghy0925@163.com.
authors.forename: Houyi
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. 361028683@qq.com.
authors.forename: Yulong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: State key laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, No. 10, Changjiang Zhilu, Da Ping, Yuzhong Distriction, Chongqing, 400042, China. 13638356728@163.com.
authors.forename: Huaping
authors.initials: H
authors.lastname: Liang
authors.affiliation: Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA19104, USA. Sumei.Wang@uphs.upenn.edu.
authors.forename: Sumei
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. wgzhang01@163.com.|State key laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, No. 10, Changjiang Zhilu, Da Ping, Yuzhong Distriction, Chongqing, 400042, China. wgzhang01@163.com.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply / Q000473:pathology*; D002648:Child; D005260:Female; D005910:Glioma / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D055815:Young Adult