Arterial spin labeling: Pathologically proven superiority over conventional MRI for detection of high-grade glioma progression after treatment
| Autor: | Justin M. Honce, Brian Shukri, Bette K. Kleinschmidt-DeMasters, Eric Nyberg, Sarah M. Kreidler, Lidia M. Nagae |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Contrast Media Fluid-attenuated inversion recovery 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine McNemar's test Biopsy Medicine Humans Radiology Nuclear Medicine and imaging Pseudoprogression Brain Diseases medicine.diagnostic_test business.industry Brain Neoplasms General Medicine Glioma Middle Aged Debulking Magnetic Resonance Imaging Tumor progression Cerebrovascular Circulation Arterial spin labeling Disease Progression Female Spin Labels Neurology (clinical) Radiology business Nuclear medicine Perfusion 030217 neurology & neurosurgery |
| Popis: | Background Standard of care for high-grade gliomas (HGGs) includes surgical debulking and adjuvant chemotherapy and radiation. Patients under treatment require frequent clinical and imaging monitoring for therapy modulation. Differentiating tumor progression from treatment-related changes can be challenging on conventional MRI, resulting in delayed recognition of tumor progression. Arterial spin labeling (ASL) may be more sensitive for tumor progression. Materials and methods ASL and associated conventional MR images obtained in patients previously treated for HGGs and before biopsy or re-resection were reviewed by three neuroradiologists who were blinded to the histopathologic results. Regions of interest (ROIs) of greatest perfusion were chosen by consensus, and mirror-image contralateral ROIs were also placed. Sensitivity of ASL for tumor progression was compared with those of contrast-enhanced T1-weighted (T1W-CE) and fluid-attenuated inversion recovery (FLAIR) images using McNemar’s test. We tested for an association between cerebral blood flow (CBF) and apparent diffusion correlation (ADC) using a Hotelling–Lawley trace. Finally, we used a Pearson’s analysis to test for a correlation between CBF and percentage of tumor within each resection. Results Twenty-two patients were studied. ASL demonstrated hyperperfusion in all cases with mean CBF ratio 3.37 (±1.71). T1W-CE and FLAIR images were positive in 15 ( p = 0.0233) and 16 ( p = 0.0412) cases, respectively. There was no association between ADC and CBF ( p = 0.687). There was a correlation between CBF and percentage of tumor ( p = 0.048). Conclusion ASL may be more sensitive than conventional MR sequences for the detection of tumor progression in patients treated for HGGs. |
| Databáze: | OpenAIRE |
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