title: Differentiation of high-grade and low-grade diffuse gliomas by intravoxel incoherent motion MR imaging.
abstract: BACKGROUND
  Our aim was to assess the diagnostic performance of intravoxel incoherent motion (IVIM) MR imaging for differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs).
  
  
  METHODS
  Forty-five patients with diffuse glioma (age 50.9 ± 20.4 y; 26 males, 19 females) were assessed with IVIM imaging using 13 b-values (0-1000 s/mm(2)) at 3T. The perfusion fraction (f), true diffusion coefficient (D), and pseudo-diffusion coefficient (D*) were calculated by fitting the bi-exponential model. The apparent diffusion coefficient (ADC) was obtained with 2 b-values (0 and 1000 s/mm(2)). Relative cerebral blood volume was measured by the dynamic susceptibility contrast method. Two observers independently measured D, ADC, D*, and f, and these measurements were compared between the LGG group (n = 16) and the HGG group (n = 29).
  
  
  RESULTS
  Both D (1.26 ± 0.37 mm(2)/s in LGG, 0.94 ± 0.19 mm(2)/s in HGG; P < .001) and ADC (1.28 ± 0.35 mm(2)/s in LGG, 1.03 ± 0.19 mm(2)/s in HGG; P < .01) were lower in the HGG group. D was lower than ADC in the LGG (P < .05) and HGG groups (P < .0001). D* was not different between the groups. The f-values were significantly larger in HGG (17.5 ± 6.3%) than in LGG (5.8 ± 3.8%; P < .0001) and correlated with relative cerebral blood volume (r = 0.85; P < .0001). Receiver operating characteristic analyses showed areas under curve of 0.95 with f, 0.78 with D, 0.73 with ADC, and 0.60 with D*.
  
  
  CONCLUSIONS
  IVIM imaging is useful in differentiating HGGs from LGGs.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Osamu
authors.initials: O
authors.lastname: Togao
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Akio
authors.initials: A
authors.lastname: Hiwatashi
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizoguchi
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimoto
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Satoshi O
authors.initials: SO
authors.lastname: Suzuki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Toru
authors.initials: T
authors.lastname: Iwaki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Makoto
authors.initials: M
authors.lastname: Obara
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Marc
authors.initials: M
authors.lastname: Van Cauteren
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (O.T., A.H., K.Y., K.K., H.H.); Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (M.M., K.Y.); Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (S.O.S., T.I.); Philips Electronics Japan, Tokyo, Japan (M.O., M.V.C.).
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012680:Sensitivity and Specificity
keywords: MRI; diffusion; glioma; intravoxel incoherent motion; perfusion