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Research ArticleBrain

Meta-Analysis of Diffusion Metrics for the Prediction of Tumor Grade in Gliomas

V.Z. Miloushev, D.S. Chow and C.G. Filippi
American Journal of Neuroradiology February 2015, 36 (2) 302-308; DOI: https://doi.org/10.3174/ajnr.A4097
V.Z. Miloushev
aFrom the Department of Diagnostic Radiology, Columbia University, New York, New York.
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D.S. Chow
aFrom the Department of Diagnostic Radiology, Columbia University, New York, New York.
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C.G. Filippi
aFrom the Department of Diagnostic Radiology, Columbia University, New York, New York.
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Abstract

BACKGROUND AND PURPOSE: Diffusion tensor metrics are potential in vivo quantitative neuroimaging biomarkers for the characterization of brain tumor subtype. This meta-analysis analyzes the ability of mean diffusivity and fractional anisotropy to distinguish low-grade from high-grade gliomas in the identifiable tumor core and the region of peripheral edema.

MATERIALS AND METHODS: A meta-analysis of articles with mean diffusivity and fractional anisotropy data for World Health Organization low-grade (I, II) and high-grade (III, IV) gliomas, between 2000 and 2013, was performed. Pooled data were analyzed by using the odds ratio and mean difference. Receiver operating characteristic analysis was performed for patient-level data.

RESULTS: The minimum mean diffusivity of high-grade gliomas was decreased compared with low-grade gliomas. High-grade gliomas had decreased average mean diffusivity values compared with low-grade gliomas in the tumor core and increased average mean diffusivity values in the peripheral region. High-grade gliomas had increased FA values compared with low-grade gliomas in the tumor core, decreased values in the peripheral region, and a decreased fractional anisotropy difference between the tumor core and peripheral region.

CONCLUSIONS: The minimum mean diffusivity differs significantly with respect to the World Health Organization grade of gliomas. Statistically significant effects of tumor grade on average mean diffusivity and fractional anisotropy were observed, supporting the concept that high-grade tumors are more destructive and infiltrative than low-grade tumors. Considerable heterogeneity within the literature may be due to systematic factors in addition to underlying lesion heterogeneity.

ABBREVIATIONS:

ΔFA
fractional anisotropy difference
FA
fractional anisotropy
MD
mean diffusivity
minMD
minimum mean diffusivity or minimum ADC
ROC
receiver operator characteristic
WHO
World Health Organization
  • © 2015 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 36 (2)
American Journal of Neuroradiology
Vol. 36, Issue 2
1 Feb 2015
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Meta-Analysis of Diffusion Metrics for the Prediction of Tumor Grade in Gliomas
V.Z. Miloushev, D.S. Chow, C.G. Filippi
American Journal of Neuroradiology Feb 2015, 36 (2) 302-308; DOI: 10.3174/ajnr.A4097

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Meta-Analysis of Diffusion Metrics for the Prediction of Tumor Grade in Gliomas
V.Z. Miloushev, D.S. Chow, C.G. Filippi
American Journal of Neuroradiology Feb 2015, 36 (2) 302-308; DOI: 10.3174/ajnr.A4097
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