RT Journal Article
SR Electronic
T1 A Prospective Study on the Added Value of Pulsed Arterial Spin-Labeling and Apparent Diffusion Coefficients in the Grading of Gliomas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1693
OP 1699
DO 10.3174/ajnr.A0674
VO 28
IS 9
A1 H.S. Kim
A1 S.Y. Kim
YR 2007
UL http://www.ajnr.org/content/28/9/1693.abstract
AB BACKGROUND AND PURPOSE: The purpose of this study was to determine whether qualitative and quantitative measures obtained with pulsed arterial spin-labeling (PASL) and apparent diffusion coefficients (ADC) improve glioma grading compared with conventional MR images.MATERIALS AND METHODS: We prospectively performed 2 qualitative consensus reviews in 33 suspected gliomas: 1) conventional MR images alone and 2) conventional MR images with PASL and ADC. To calculate the diagnostic performance parameters of PASL and ADC, we used a qualitative scoring system on the basis of the tumor perfusion signal intensity (sTP) and visual ADC scoring (sADC). We then analyzed quantitative regions of interest and calculated the ratio of the maximum tumor perfusion signal intensity (rTPmax) and the minimum ADC value (mADC).RESULTS: Two observers diagnosed accurate tumor grades in 23 of 33 (70%) lesions in the first review and in 29 of 33 (88%) lesions in the second review. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for determining a glioma grading by using combined sTP and sADC scoring were 90.9, 90.9, 95.2, and 83.3%, respectively. Statistical analysis gave a threshold value of 1.24 for rTPmax and 0.98 × 10–3 mm/s2 for mADC to provide a sensitivity, specificity, PPV, and NPV of 95.5, 81.8, 91.3, and 90.1% and 90.9, 81.8, 90.9, and 81.8%, respectively. The receiver operator characteristic curve analyses showed no significant difference between the quantitative and combined qualitative parameters.CONCLUSION: PASL and ADC significantly improve the diagnostic accuracy of glioma grading compared with conventional imaging.