ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Neuroradiology
abstract:
Original paper

Multi-parametric arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of grade II and grade III gliomas

Ahmed Abdel Khalek Abdel Razek
1
,
Lamiaa Galal El-Serougy
1
,
Mohamed A. Abdelsalam
2
,
Gada Mohamed Gaballa
1
,
Mona Mohamed Talaat
3

1.
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
2.
Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt
3.
Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Mansoura, Egypt
© Pol J Radiol 2020; 85: e110-e117
Online publish date: 2020/02/21
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Purpose
To assess arterial spin labelling (ASL) perfusion and diffusion MR imaging (DWI) in the differentiation of grade II from grade III gliomas.

Material and methods
A prospective cohort study was done on 36 patients (20 male and 16 female) with diffuse gliomas, who underwent ASL and DWI. Diffuse gliomas were classified into grade II and grade III. Calculation of tumoural blood flow (TBF) and apparent diffusion coefficient (ADC) of the tumoral and peritumoural regions was made. The ROC curve was drawn to differentiate grade II from grade III gliomas.

Results
There was a significant difference in TBF of tumoural and peritumoural regions of grade II and III gliomas (p = 0.02 and p =0.001, respectively). Selection of 26.1 and 14.8 ml/100 g/min as the cut-off for TBF of tumoural and peritumoural regions differentiated between both groups with area under curve (AUC) of 0.69 and 0.957, and accuracy of 77.8% and 88.9%, respectively. There was small but significant difference in the ADC of tumoural and peritumoural regions between grade II and III gliomas (p = 0.02 for both). The selection of 1.06 and 1.36 × 10-3 mm2/s as the cut-off of ADC of tumoural and peritumoural regions was made, to differentiate grade II from III with AUC of 0.701 and 0.748, and accuracy of 80.6% and 80.6%, respectively. Combined TBF and ADC of tumoural regions revealed an AUC of 0.808 and accuracy of 72.7%. Combined TBF and ADC for peritumoural regions revealed an AUC of 0.96 and accuracy of 94.4%.

Conclusion
TBF and ADC of tumoural and peritumoural regions are accurate non-invasive methods of differentiation of grade II from grade III gliomas.

keywords:

arterial spin labelling, diffusion weighted imaging, glioma, grading

 
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