<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2017-0010_s_001_w2aab3b8c31b1b7b1aab1c17b1Aa"><h3>Background</h3><p>Diffusion kurtosis imaging (DKI) allows for assessment of diffusion influenced by microcellular structures. We analyzed DKI in suspected low-grade gliomas prior to histopathological diagnosis. The aim was to investigate if diffusion parameters in the perilesional normal-appearing white matter (NAWM) differed from contralesional white matter, and to investigate differences between glioma malignancy grades II and III and glioma subtypes (astrocytomas and oligodendrogliomas).</p></sec><sec id="j_raon-2017-0010_s_002_w2aab3b8c31b1b7b1aab1c17b2Aa"><h3>Patients and methods</h3><p>Forty-eight patients with suspected low-grade glioma were prospectively recruited to this institutional review board-approved study and investigated with preoperative DKI at 3T after written informed consent. Patients with histologically proven glioma grades II or III were further analyzed (n=35). Regions of interest (ROIs) were delineated on T2FLAIR images and co-registered to diffusion MRI parameter maps. Mean DKI data were compared between perilesional and contralesional NAWM (student’s <italic>t</italic>-test for dependent samples, Wilcoxon matched pairs test). Histogram DKI data were compared between glioma types and glioma grades (multiple comparisons of mean ranks for all groups). The discriminating potential for DKI in assessing glioma type and grade was assessed with receiver operating characteristics (ROC) curves.</p></sec><sec id="j_raon-2017-0010_s_003_w2aab3b8c31b1b7b1aab1c17b3Aa"><h3>Results</h3><p>There were significant differences in all mean DKI variables between perilesional and contralesional NAWM (<italic>p</italic>=&lt;0.000), except for axial kurtosis (<italic>p</italic>=0.099). Forty-four histogram variables differed significantly between glioma grades II (n=23) and III (n=12) (p=0.003−0.048) and 10 variables differed significantly between ACs (n=18) and ODs (n=17) (<italic>p</italic>=0.011−0.050). ROC curves of the best discriminating variables had an area under the curve (AUC) of 0.657−0.815.</p></sec><sec id="j_raon-2017-0010_s_004_w2aab3b8c31b1b7b1aab1c17b4Aa"><h3>Conclusions</h3><p>Mean DKI variables in perilesional NAWM differ significantly from contralesional NAWM, suggesting altered microstructure by tumor infiltration not depicted on morphological MRI. Histogram analysis of DKI data identifies differences between glioma grades and subtypes.</p></sec></abstract>

BackgroundDiffusion kurtosis imaging (DKI) allows for assessment of diffusion influenced by microcellular structures. We analyzed DKI in suspected low-grade gliomas prior to histopathological diagnosis. The aim was to investigate if diffusion parameters in the perilesional normal-appearing white matter (NAWM) differed from contralesional white matter, and to investigate differences between glioma malignancy grades II and III and glioma subtypes (astrocytomas and oligodendrogliomas).Patients and methodsForty-eight patients with suspected low-grade glioma were prospectively recruited to this institutional review board-approved study and investigated with preoperative DKI at 3T after written informed consent. Patients with histologically proven glioma grades II or III were further analyzed (n=35). Regions of interest (ROIs) were delineated on T2FLAIR images and co-registered to diffusion MRI parameter maps. Mean DKI data were compared between perilesional and contralesional NAWM (student’s t-test for dependent samples, Wilcoxon matched pairs test). Histogram DKI data were compared between glioma types and glioma grades (multiple comparisons of mean ranks for all groups). The discriminating potential for DKI in assessing glioma type and grade was assessed with receiver operating characteristics (ROC) curves.ResultsThere were significant differences in all mean DKI variables between perilesional and contralesional NAWM (p=<0.000), except for axial kurtosis (p=0.099). Forty-four histogram variables differed significantly between glioma grades II (n=23) and III (n=12) (p=0.003−0.048) and 10 variables differed significantly between ACs (n=18) and ODs (n=17) (p=0.011−0.050). ROC curves of the best discriminating variables had an area under the curve (AUC) of 0.657−0.815.ConclusionsMean DKI variables in perilesional NAWM differ significantly from contralesional NAWM, suggesting altered microstructure by tumor infiltration not depicted on morphological MRI. Histogram analysis of DKI data identifies differences between glioma grades and subtypes.

Diffusion kurtosis imaging of gliomas grades II and III - a study of perilesional tumor infiltration, tumor grades and subtypes at clinical presentation

Radiology and Oncology

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

BackgroundDiffusion kurtosis imaging (DKI) allows for assessment of diffusion influenced by microcellular structures. We analyzed DKI in suspected low-grade...

Diffusion kurtosis imaging of gliomas grades II and III - a study of perilesional tumor infiltration, tumor grades and subtypes at clinical presentation

Article Category: Research Articles

Publicado en línea: 15 feb 2017

Páginas: 121 - 129

Recibido: 15 ago 2016

Aceptado: 08 ene 2017

DOI: https://doi.org/10.1515/raon-2017-0010

© 2017 Anna F. Delgado, Markus Fahlström, Markus Nilsson, Shala G. Berntsson, Maria Zetterling, Sylwia Libard, Irina Alafuzoff, Danielle van Westen, Jimmy Lätt, Anja Smits, Elna-Marie Larsson

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.