Local image variance of 7 Tesla SWI is a new technique for preoperative characterization of diffusely infiltrating gliomas: correlation with tumour grade and IDH1 mutational status.
OBJECTIVE
To investigate the value of local image variance (LIV) as a new technique for quantification of hypointense microvascular susceptibility-weighted imaging (SWI) structures at 7 Tesla for preoperative glioma characterization.


METHODS
Adult patients with neuroradiologically suspected diffusely infiltrating gliomas were prospectively recruited and 7 Tesla SWI was performed in addition to standard imaging. After tumour segmentation, quantification of intratumoural SWI hypointensities was conducted by the SWI-LIV technique. Following surgery, the histopathological tumour grade and isocitrate dehydrogenase 1 (IDH1)-R132H mutational status was determined and SWI-LIV values were compared between low-grade gliomas (LGG) and high-grade gliomas (HGG), IDH1-R132H negative and positive tumours, as well as gliomas with significant and non-significant contrast-enhancement (CE) on MRI.


RESULTS
In 30 patients, 9 LGG and 21 HGG were diagnosed. The calculation of SWI-LIV values was feasible in all tumours. Significantly higher mean SWI-LIV values were found in HGG compared to LGG (92.7 versus 30.8; p < 0.0001), IDH1-R132H negative compared to IDH1-R132H positive gliomas (109.9 versus 38.3; p < 0.0001) and tumours with significant CE compared to non-significant CE (120.1 versus 39.0; p < 0.0001).


CONCLUSIONS
Our data indicate that 7 Tesla SWI-LIV might improve preoperative characterization of diffusely infiltrating gliomas and thus optimize patient management by quantification of hypointense microvascular structures.


CONCLUSIONS
• 7 Tesla local image variance helps to quantify hypointense susceptibility-weighted imaging structures. • SWI-LIV is significantly increased in high-grade and IDH1-R132H negative gliomas. • SWI-LIV is a promising technique for improved preoperative glioma characterization. • Preoperative management of diffusely infiltrating gliomas will be optimized.
High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Health Sciences and Social Work, Carinthia University of Applied Sciences, St. Veiterstraße 47, 9020, Klagenfurt am Wörthersee, Austria.
Günther
G
Grabner
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Barbara
B
Kiesel
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Institute of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Adelheid
A
Wöhrer
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Matthias
M
Millesi
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Aygül
A
Wurzer
High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Sabine
S
Göd
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Ammar
A
Mallouhi
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Engelbert
E
Knosp
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Christine
C
Marosi
High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Siegfried
S
Trattnig
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Stefan
S
Wolfsberger
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.|Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
Matthias
M
Preusser
Comprehensive Cancer Center, Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria. georg.widhalm@meduniwien.ac.at.|Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria. georg.widhalm@meduniwien.ac.at.
Georg
G
Widhalm
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D060787:Neoplasm Grading; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
7 Tesla MRI; Diffusely infiltrating gliomas; Glioma characterization; Local image variance; Susceptibility-weighted imaging