A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy
Background: The primary aim of this study was to evaluate the individual and combined efficacy of magnetic resonance imaging (MRI) parameters, which include MRI perfusion, MRI diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) in the grading of gliomas as low grade versus hig...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Clinical and Scientific Research |
| Subjects: | |
| Online Access: | http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=3;spage=150;epage=156;aulast=Chopra |
| _version_ | 1811313186762129408 |
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| author | Himanshu Chopra Rahat Brar Deepander Singh Rathore Ankur Dwivedi Abhishek Prasad Shaleen Rana Manish Budhiraja Sachin Ranganatha Goudihalli Paramdeep Singh |
| author_facet | Himanshu Chopra Rahat Brar Deepander Singh Rathore Ankur Dwivedi Abhishek Prasad Shaleen Rana Manish Budhiraja Sachin Ranganatha Goudihalli Paramdeep Singh |
| author_sort | Himanshu Chopra |
| collection | DOAJ |
| description | Background: The primary aim of this study was to evaluate the individual and combined efficacy of magnetic resonance imaging (MRI) parameters, which include MRI perfusion, MRI diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) in the grading of gliomas as low grade versus high grade. The pre-operative imaging-based grading of gliomas by multiparametric MRI was compared with the gold standard histopathological studies.
Methods: A total of 22 patients referred to the radiology department for multiparametric MRI of the brain with presumptive diagnosis of glioma on computed tomography/MRI were included in the study. Conventional T1, T2 and fluid-attenuated inversion recovery images were obtained followed by perfusion MRI using gadopentetate dimeglumine (Magnevist) administration. This was followed by DWI and MRS.
Results: Our statistical analysis demonstrated that a cut-off of apparent diffusion coefficient value of 954.085 (10–6 mm2/Sec) provides a sensitivity and specificity of 87.5% and 85.7%, respectively, in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). A choline/creatine ratio cut-off value of 2 provides sensitivity and specificity of 100% and 92.9%, respectively, while a cut-off value of 1.45 of choline/N-acetylaspartate ratio provides both sensitivity and specificity of 100% in differentiating LGG from HGG. A cut-off of 1.9 for maximum relative cerebral blood volume (rCBV) value provides both sensitivity and specificity of 100% in differentiating LGGs from HGGs.
Conclusions: We concluded that perfusion MRI (rCBV) was the best parameter among perfusion MRI, DWI and MRI spectroscopy in differentiating HGGs from LGGs. Combined multiparametric results showed a diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 86.4%, 82.4%, 100%, 100% and 62.5%, respectively, on comparison with gold standard histopathological grading. |
| first_indexed | 2024-04-13T10:49:34Z |
| format | Article |
| id | doaj.art-c417ddbd76fa46a684a4aad1c64b4977 |
| institution | Directory Open Access Journal |
| issn | 2277-5706 2277-8357 |
| language | English |
| last_indexed | 2024-04-13T10:49:34Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
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| series | Journal of Clinical and Scientific Research |
| spelling | doaj.art-c417ddbd76fa46a684a4aad1c64b49772022-12-22T02:49:42ZengWolters Kluwer Medknow PublicationsJournal of Clinical and Scientific Research2277-57062277-83572022-01-0111315015610.4103/jcsr.jcsr_50_22A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopyHimanshu ChopraRahat BrarDeepander Singh RathoreAnkur DwivediAbhishek PrasadShaleen RanaManish BudhirajaSachin Ranganatha GoudihalliParamdeep SinghBackground: The primary aim of this study was to evaluate the individual and combined efficacy of magnetic resonance imaging (MRI) parameters, which include MRI perfusion, MRI diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) in the grading of gliomas as low grade versus high grade. The pre-operative imaging-based grading of gliomas by multiparametric MRI was compared with the gold standard histopathological studies. Methods: A total of 22 patients referred to the radiology department for multiparametric MRI of the brain with presumptive diagnosis of glioma on computed tomography/MRI were included in the study. Conventional T1, T2 and fluid-attenuated inversion recovery images were obtained followed by perfusion MRI using gadopentetate dimeglumine (Magnevist) administration. This was followed by DWI and MRS. Results: Our statistical analysis demonstrated that a cut-off of apparent diffusion coefficient value of 954.085 (10–6 mm2/Sec) provides a sensitivity and specificity of 87.5% and 85.7%, respectively, in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). A choline/creatine ratio cut-off value of 2 provides sensitivity and specificity of 100% and 92.9%, respectively, while a cut-off value of 1.45 of choline/N-acetylaspartate ratio provides both sensitivity and specificity of 100% in differentiating LGG from HGG. A cut-off of 1.9 for maximum relative cerebral blood volume (rCBV) value provides both sensitivity and specificity of 100% in differentiating LGGs from HGGs. Conclusions: We concluded that perfusion MRI (rCBV) was the best parameter among perfusion MRI, DWI and MRI spectroscopy in differentiating HGGs from LGGs. Combined multiparametric results showed a diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 86.4%, 82.4%, 100%, 100% and 62.5%, respectively, on comparison with gold standard histopathological grading.http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=3;spage=150;epage=156;aulast=Chopragliomagradingmagnetic resonance imagingmagnetic resonance imaging diffusionmagnetic resonance imaging perfusionmagnetic resonance spectroscopymultiparametric |
| spellingShingle | Himanshu Chopra Rahat Brar Deepander Singh Rathore Ankur Dwivedi Abhishek Prasad Shaleen Rana Manish Budhiraja Sachin Ranganatha Goudihalli Paramdeep Singh A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy Journal of Clinical and Scientific Research glioma grading magnetic resonance imaging magnetic resonance imaging diffusion magnetic resonance imaging perfusion magnetic resonance spectroscopy multiparametric |
| title | A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| title_full | A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| title_fullStr | A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| title_full_unstemmed | A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| title_short | A prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| title_sort | prospective study to evaluate the role of multiparametric magnetic resonance imaging in the grading of gliomas using magnetic resonance imaging perfusion and diffusion and multivoxel magnetic resonance spectroscopy |
| topic | glioma grading magnetic resonance imaging magnetic resonance imaging diffusion magnetic resonance imaging perfusion magnetic resonance spectroscopy multiparametric |
| url | http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=3;spage=150;epage=156;aulast=Chopra |
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