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Research ArticleBrain

Diagnostic Accuracy of Dynamic Contrast-Enhanced MR Imaging Using a Phase-Derived Vascular Input Function in the Preoperative Grading of Gliomas

T.B. Nguyen, G.O. Cron, J.F. Mercier, C. Foottit, C.H. Torres, S. Chakraborty, J. Woulfe, G.H. Jansen, J.M. Caudrelier, J. Sinclair, M.J. Hogan, R.E. Thornhill and I.G. Cameron
American Journal of Neuroradiology September 2012, 33 (8) 1539-1545; DOI: https://doi.org/10.3174/ajnr.A3012
T.B. Nguyen
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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G.O. Cron
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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J.F. Mercier
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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C. Foottit
bMedical Physics (C.F., I.G.C.)
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C.H. Torres
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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S. Chakraborty
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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J. Woulfe
cPathology (G.H.J., J.W.)
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G.H. Jansen
cPathology (G.H.J., J.W.)
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J.M. Caudrelier
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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J. Sinclair
dSurgery, Division of Neurosurgery (J.S.)
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M.J. Hogan
eMedicine, Division of Neurology (M.J.H.); The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
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R.E. Thornhill
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
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I.G. Cameron
aFrom the Departments of Radiology (T.B.N., G.O.C., J.F.M., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
bMedical Physics (C.F., I.G.C.)
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Abstract

BACKGROUND AND PURPOSE: The accuracy of tumor plasma volume and Ktrans estimates obtained with DCE MR imaging may have inaccuracies introduced by a poor estimation of the VIF. In this study, we evaluated the diagnostic accuracy of a novel technique by using a phase-derived VIF and “bookend” T1 measurements in the preoperative grading of patients with suspected gliomas.

MATERIALS AND METHODS: This prospective study included 46 patients with a new pathologically confirmed diagnosis of glioma. Both magnitude and phase images were acquired during DCE MR imaging for estimates of Ktrans_ϕ and Vp_ϕ (calculated from a phase-derived VIF and bookend T1 measurements) as well as Ktrans_SI and Vp_SI (calculated from a magnitude-derived VIF without T1 measurements).

RESULTS: Median Ktrans_ϕ values were 0.0041 minutes−1 (95 CI, 0.00062–0.033), 0.031 minutes−1 (0.011–0.150), and 0.088 minutes−1 (0.069–0.110) for grade II, III, and IV gliomas, respectively (P ≤ .05 for each). Median Vp_ϕ values were 0.64 mL/100 g (0.06–1.40), 0.98 mL/100 g (0.34–2.20), and 2.16 mL/100 g (1.8–3.1) with P = .15 between grade II and III gliomas and P = .015 between grade III and IV gliomas. In differentiating low-grade from high-grade gliomas, AUCs for Ktrans_ϕ, Vp_ϕ, Ktrans_SI, and Vp_SI were 0.87 (0.73–1), 0.84 (0.69–0.98), 0.81 (0.59–1), and 0.84 (0.66–0.91). The differences between the AUCs were not statistically significant.

CONCLUSIONS: Ktrans_ϕ and Vp_ϕ are parameters that can help in differentiating low-grade from high-grade gliomas.

ABBREVIATIONS:

AUC
area under the receiver operating characteristic curve
CT(t)
tissue contrast concentration curve with time
CI
confidence interval
CV
coefficient of variation
DCE
dynamic contrast-enhanced
Ktrans_ϕ
volume transfer coefficient obtained from phase-derived vascular input function
Ktrans_SI
volume transfer coefficient obtained from magnitude-derived vascular input function
NPV
negative predictive value
PPV
positive predictive value
R1
rate of longitudinal relaxation
R2*
observed rate of transverse relaxation
ROC
receiver operating characteristic analysis
T1
longitudinal relaxation time
Vp_SI
plasma volume obtained from magnitude-derived vascular input function
VIF
vascular input function
Vp_ϕ
plasma volume obtained from phase-derived vascular input function
  • © 2012 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 33 (8)
American Journal of Neuroradiology
Vol. 33, Issue 8
1 Sep 2012
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Diagnostic Accuracy of Dynamic Contrast-Enhanced MR Imaging Using a Phase-Derived Vascular Input Function in the Preoperative Grading of Gliomas
T.B. Nguyen, G.O. Cron, J.F. Mercier, C. Foottit, C.H. Torres, S. Chakraborty, J. Woulfe, G.H. Jansen, J.M. Caudrelier, J. Sinclair, M.J. Hogan, R.E. Thornhill, I.G. Cameron
American Journal of Neuroradiology Sep 2012, 33 (8) 1539-1545; DOI: 10.3174/ajnr.A3012

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Diagnostic Accuracy of Dynamic Contrast-Enhanced MR Imaging Using a Phase-Derived Vascular Input Function in the Preoperative Grading of Gliomas
T.B. Nguyen, G.O. Cron, J.F. Mercier, C. Foottit, C.H. Torres, S. Chakraborty, J. Woulfe, G.H. Jansen, J.M. Caudrelier, J. Sinclair, M.J. Hogan, R.E. Thornhill, I.G. Cameron
American Journal of Neuroradiology Sep 2012, 33 (8) 1539-1545; DOI: 10.3174/ajnr.A3012
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