Non-Gaussian diffusion MR imaging of glioma: comparisons of multiple diffusion parameters and correlation with histologic grade and MIB-1 (Ki-67 labeling) index.
BACKGROUND
This study was conducted to compare the association of Gaussian and non-Gaussian magnetic resonance imaging (MRI)-derived parameters with histologic grade and MIB-1 (Ki-67 labeling) index (MI) in brain glioma.


METHODS
Sixty-five patients with pathologically confirmed glioma, who underwent diffusion-weighted MRI with 2 b values (0, 1000 s/mm(2)) and 22 b values (≤5000 s/mm(2)), respectively, were divided into three groups of grade II (n = 35), grade III (n = 8), and grade IV (n = 22). Comparisons by two groups were made for apparent diffusion coefficient (ADC), slow diffusion coefficient (Dslow), distributed diffusion coefficient (DDC), and heterogeneity index α. Analyses of receiver operating characteristic (ROC) curve were performed to maximize the area under the curve (AUC) for differentiating grade III + IV (high-grade glioma, HGG) from grade II (low-grade glioma, LGG) and grade IV (glioblastoma multiforme, GBM) from grade II + III (other grade glioma, OGG). Correlations with MI were analyzed for the MRI parameters.


RESULTS
On tumor regions, the values of ADC, Dslow, DDC, and α were significantly higher in grade II [(1.37 ± 0.29, 0.70 ± 0.11, 1.39 ± 0.34) (×10(-3) mm(2)/s) and 0.88 ± 0.05, respectively] than in grade III [(0.99 ± 0.13, 0.55 ± 0.07, 1.04 ± 0.20) (×10(-3) mm(2)/s) and 0.80 ± 0.03, respectively] and grade IV [(1.03 ± 0.14, 0.50 ± 0.05, 1.02 ± 0.16) (×10(-3) mm(2)/s) and 0.76 ± 0.04, respectively] (all P < 0.001). The parameter α showed the highest AUCs of 0.950 and 0.922 in discriminating HGG from LGG and GBM from OGG, respectively. Significant correlations with histologic grade and MI were observed for the MRI parameters.


CONCLUSIONS
The non-Gaussian MRI-derived parameters α and Dslow are superior to ADC in glioma grading, which are comparable with ADC as reliable biomarkers in noninvasively predicting the proliferation level of glioma malignancy.
Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Ren
R
Yan
Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Pang
P
Haopeng
Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China. xyfeng@shmu.edu.cn.
Feng
F
Xiaoyuan
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China.
Wu
W
Jinsong
Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Zhang
Z
Jiawen
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China.
Yao
Y
Chengjun
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China.
Qiu
Q
Tianming
Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, PR China.
Xiong
X
Ji
Department of Imaging, Suzhou Children's Hospital, Suzhou, Jiangsu, PR China.
Sheng
S
Mao
Department of Imaging, Suzhou Children's Hospital, Suzhou, Jiangsu, PR China.
Ding
D
Yueyue
MR Research, GE Healthcare, Shanghai, PR China.
Zhang
Z
Yong
Department of Biostatistics, Public Health School, Fudan University, Shanghai, PR China.
Luo
L
Jianfeng
Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Yao
Y
Zhenwei
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D016011:Normal Distribution; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
D019394:Ki-67 Antigen
Biexponential model; Glioma grading; MIB-1 (Ki-67 labeling) index; Non-Gaussian diffusion MRI; Stretched-exponential model