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- Title
Differentiation of high-grade from low-grade diffuse gliomas using diffusion-weighted imaging: a comparative study of mono-, bi-, and stretched-exponential diffusion models.
- Authors
Kusunoki, Masaoki; Kikuchi, Kazufumi; Togao, Osamu; Yamashita, Koji; Momosaka, Daichi; Kikuchi, Yoshitomo; Kuga, Daisuke; Hata, Nobuhiro; Mizoguchi, Masahiro; Iihara, Koji; Suzuki, Satoshi O.; Iwaki, Toru; Akamine, Yuta; Hiwatashi, Akio
- Abstract
Purpose: Diffusion-weighted imaging (DWI) plays an important role in the preoperative assessment of gliomas; however, the diagnostic performance of histogram-derived parameters from mono-, bi-, and stretched-exponential DWI models in the grading of gliomas has not been fully investigated. Therefore, we compared these models' ability to differentiate between high-grade and low-grade gliomas. Methods: This retrospective study included 22 patients with diffuse gliomas (age, 23–74 years; 12 males; 11 high-grade and 11 low-grade gliomas) who underwent preoperative 3 T-magnetic resonance imaging from October 2014 to August 2019. The apparent diffusion coefficient was calculated from the mono-exponential model. Using 13 b-values, the true-diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction were obtained from the bi-exponential model, and the distributed-diffusion coefficient and heterogeneity index were obtained from the stretched-exponential model. Region-of-interests were drawn on each imaging parameter map for subsequent histogram analyses. Results: The skewness of the apparent diffusion, true-diffusion, and distributed-diffusion coefficients was significantly higher in high-grade than in low-grade gliomas (0.67 ± 0.67 vs. − 0.18 ± 0.63, 0.68 ± 0.74 vs. − 0.08 ± 0.66, 0.63 ± 0.72 vs. − 0.15 ± 0.73; P = 0.0066, 0.0192, and 0.0128, respectively). The 10th percentile of the heterogeneity index was significantly lower (0.77 ± 0.08 vs. 0.88 ± 0.04; P = 0.0004), and the 90th percentile of the perfusion fraction was significantly higher (12.64 ± 3.44 vs. 7.14 ± 1.70%: P < 0.0001), in high-grade than in low-grade gliomas. The combination of the 10th percentile of the true-diffusion coefficient and 90th percentile of the perfusion fraction showed the best area under the receiver operating characteristic curve (0.96). Conclusion: The bi-exponential model exhibited the best diagnostic performance for differentiating high-grade from low-grade gliomas.
- Subjects
BIOLOGICAL models; COMPARATIVE studies; GLIOMAS; DIGITAL image processing; MAGNETIC resonance imaging; PREOPERATIVE care; RETROSPECTIVE studies; RECEIVER operating characteristic curves; DESCRIPTIVE statistics
- Publication
Neuroradiology, 2020, Vol 62, Issue 7, p815
- ISSN
0028-3940
- Publication type
Article
- DOI
10.1007/s00234-020-02456-2