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Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI perfusion

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

The aim of this study was to compare arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) MRI perfusion with respect to diagnostic performance in tumor grading in pediatric patients with low- and high-grade astrocytic tumors (AT).

Methods

We retrospectively analyzed 37 children with histologically proven treatment naive low- and high-grade AT who underwent concomitant pre-operative ASL and DSC MRI perfusion. Studies were performed on a 1.5 T scanner, and a pulsed technique was used for ASL. DSC data were post-processed with a leakage correction software. Normalization of tumor perfusion parameters was performed with contralateral normal appearing gray matter. Normalized cerebral blood volume (nCBV) values in the most perfused area of each neoplasm were compared with normalized DSC-derived cerebral blood flow (nDSC-CBF) and ASL-derived cerebral blood flow (nASL-CBF) data, and correlated with WHO tumor grade. Statistics included Pearson’s chi-square and Mann-Whitney U tests, Spearman’s rank correlation, and receiver operating characteristic (ROC) analysis.

Results

A significant correlation was demonstrated between DSC and ASL data (p < 0.001). Significant differences in terms of DSC and ASL data were found between low- and high-grade AT (p < 0.001). ROC analysis demonstrated similar performances between all parameters in predicting tumor grade (nCBV: AUC 0.96, p < 0.001; nDSC-CBF: AUC 0.98, p < 0.001; nASL-CBF: AUC 0.96, p < 0.001).

Conclusions

Normalized pulsed ASL performed with a 1.5 T scanner provides comparable results to DSC MRI perfusion in pediatric AT and may allow distinction between high- and low-grade AT.

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Authors and Affiliations

  1. Neuroradiology Unit, Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147, Genoa, Italy

    Giovanni Morana, Domenico Tortora, Mariasavina Severino & Andrea Rossi

  2. Radiology Department, Fondazione Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, Rome, Italy

    Serena Staglianò

  3. Pathology Unit, Ospedali Galliera, Genoa, Italy

    Paolo Nozza

  4. Neurosurgery Unit, Istituto Giannina Gaslini, Genoa, Italy

    Samantha Mascelli, Gianluca Piatelli & Alessandro Consales

  5. Department of Radiology, University Medical Center, Utrecht, The Netherlands

    Maarten Lequin

  6. Neuro-oncology Unit, Istituto Giannina Gaslini, Genoa, Italy

    Maria Luisa Garrè

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  1. Giovanni Morana
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Correspondence to Giovanni Morana.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Morana, G., Tortora, D., Staglianò, S. et al. Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI perfusion. Neuroradiology 60, 437–446 (2018). https://doi.org/10.1007/s00234-018-1992-6

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  • DOI: https://doi.org/10.1007/s00234-018-1992-6

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