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Research ArticleBRAIN

Histogram Analysis versus Region of Interest Analysis of Dynamic Susceptibility Contrast Perfusion MR Imaging Data in the Grading of Cerebral Gliomas

M. Law, R. Young, J. Babb, E. Pollack and G. Johnson
American Journal of Neuroradiology April 2007, 28 (4) 761-766;
M. Law
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R. Young
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J. Babb
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E. Pollack
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G. Johnson
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  • Fig 1.
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    Fig 1.

    Sample histogram. Percentile mean and SD measures are calculated from the top 50%, 25%, and 10% of the histogram curve. Skewness is zero if the data are distributed symmetrically around the mean, negative if the data are more spread out on the left of the mean, and positive if the data are more spread out on the right of the mean. Kurtosis, a measure of how “peaked” the histogram is, equals zero if the histogram is Gaussian, is positive if the histogram has a sharper peak, and is negative if it has a flatter top.

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    Fig 2.

    Low-grade glioma (grade II/IV) in left frontal lobe, T2-weighted (A) and contrast T1-weighted (B) images. The rCBVmax method uses 4 small ROIs targeted to foci of greatest perfusion on the rCBV map (C), with the maximal rCBV recorded from the subsequent perfusion curves (E). The signal intensity curves from each of the 5 ROIs are denoted as S1, S2, S3, S4, and S5, where S1 is the signal intensity curve for the ROI placed in normal brain and S2–S5 are the other ROIs placed in the tumoral tissue. These 5 signal intensity curves were obtained from a single section from the perfusion dataset. The rCBV histogram method uses a single ROI (D) that encompasses the maximal tumor diameter to generate the histogram curve (F), from which multiple metrics are derived.

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    Fig 3.

    High-grade glioma, glioblastoma multiforme (grade IV/IV) in frontal lobes spanning the corpus callosum. T2-weighted (A) and contrast T1-weighted (B) images are shown along with rCBVmax map (C) with ROIs targeted to avoid areas of radiologic necrosis to determine perfusion curves (E). rCBV histogram map (D) and histogram curve (F) are derived from the maximal tumor diameter regardless of heterogeneity.

Tables

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    Table 1:

    Mean ± SD for rCBV histogram measures

    Grade
    IIIIIIV
    Median1.14 ± 0.492.86 ± 1.132.72 ± 0.68
    Mean1.24 ± 0.472.90 ± 0.832.83 ± 0.68
    SD0.49 ± 0.322.31 ± 0.322.32 ± 0.29
    Mean501.58 ± 0.583.65 ± 0.933.63 ± 0.86
    SD500.46 ± 0.361.96 ± 0.311.94 ± 0.32
    Mean251.85 ± 0.664.12 ± 0.824.12 ± 0.81
    SD250.38 ± 0.331.80 ± 0.341.70 ± 0.33
    Mean102.18 ± 0.764.55 ± 0.764.46 ± 0.71
    SD100.35 ± 0.331.64 ± 0.421.54 ± 0.31
    Skew1.07 ± 0.830.46 ± 1.120.46 ± 0.78
    Kurt1.60 ± 3.040.59 ± 3.43−0.26 ± 1.18
    PH0.22 ± 0.090.20 ± 0.180.19 ± 0.16
    PP1.10 ± 0.613.28 ± 1.853.34 ± 1.75
    A1SD0.66 ± 0.110.55 ± 0.200.55 ± 0.18
    • Note:—rCBV indicates relative cerebral blood volume; mean50, mean of the top 50% of the histogram; SD50, SD of the top 50%; mean25, mean of the top 25%; SD25, SD of the top 25%; mean10, mean of the top 10%; SD10, SD of the top 10%; skew, skewness; kurt, kurtosis; PH, peak height of the histogram; PP, peak position (ie, the mode); and A1SD, area under the histogram curve within 1 SD.

    • View popup
    Table 2:

    rCBVT histogram metrics compared with rCBVmax and glioma grade, with correlation factors (r values) and Bonferroni-corrected significance <.005 (P values)

    rCBVmaxGrade
    r valueP valuer valueP value
    Median0.68880<.00010.65849<.0001
    Mean0.69444<.00010.67710<.0001
    SD0.66036<.00010.71758<.0001
    Mean500.68600<.00010.68166<.0001
    SD500.53042<.00010.68441<.0001
    Mean250.66355<.00010.68254<.0001
    SD250.53365<.00010.66394<.0001
    Mean100.63072<.00010.66342<.0001
    SD100.57135<.00010.67416<.0001
    Skew−0.42895<.0001−0.26876.0096
    Kurt−0.29511.0043−0.34505.0008
    PH−0.11601.2708−0.21640.0383
    PP0.63647<.00010.62906<.0001
    A1SD−0.22241.0331−0.23301.0254
    • Note:—rCBV indicates relative cerebral blood volume; mean50, mean of the top 50% of the histogram; SD50, SD of the top 50%; mean25, mean of the top 25%; SD25, SD of the top 25%; mean10, mean of the top 10%; SD10, SD of the top 10%; skew, skewness; kurt, kurtosis; PH, peak height of the histogram; PP, peak position (ie, the mode); and A1SD, area under the histogram curve within 1 SD. The highest correlations in each category are underlined; the metrics achieving significance are in bold.

    • View popup
    Table 3:

    rCBVmax and rCBVT, thresholds with respective sensitivities, specificities, and p values

    rCBVmaxrCBVT
    High grade if metric is≥1.75≥2.15SD ≥1.7SD25 ≥1.24SD50 ≥1.35
    Sensitivity (%)98.495.195.195.195.1
    Specificity (%)67.780.710096.896.8
    P value (vs rCBVmax ≥ 1.75)<.001<.001<.001
    P value (vs rCBVmax ≥ 2.15).002.004.004
    • Note:—rCBV indicates relative cerebral blood volume; SD50, SD of the top 50%; SD25, SD of the top 25%.

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American Journal of Neuroradiology: 28 (4)
American Journal of Neuroradiology
Vol. 28, Issue 4
April 2007
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Histogram Analysis versus Region of Interest Analysis of Dynamic Susceptibility Contrast Perfusion MR Imaging Data in the Grading of Cerebral Gliomas
M. Law, R. Young, J. Babb, E. Pollack, G. Johnson
American Journal of Neuroradiology Apr 2007, 28 (4) 761-766;

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Histogram Analysis versus Region of Interest Analysis of Dynamic Susceptibility Contrast Perfusion MR Imaging Data in the Grading of Cerebral Gliomas
M. Law, R. Young, J. Babb, E. Pollack, G. Johnson
American Journal of Neuroradiology Apr 2007, 28 (4) 761-766;
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