Differentiation of High-grade from Low-grade Diffuse Gliomas Using Diffusion-weighted Imaging: a Comparative Study of Mono-, Bi-, and Stretched-exponential Diffusion Models

Overview

Journal Neuroradiology

Specialties Neurology
Radiology

Date 2020 May 20

PMID 32424712

Citations 12

Authors

Masaoki Kusunoki

Kazufumi Kikuchi

Osamu Togao

Koji Yamashita

Daichi Momosaka

Yoshitomo Kikuchi

Daisuke Kuga

Nobuhiro Hata

Masahiro Mizoguchi

Koji Iihara

Satoshi O Suzuki

Toru Iwaki

Yuta Akamine

Akio Hiwatashi

Affiliations

Soon will be listed here.

Abstract

Purpose: Diffusion-weighted imaging (DWI) plays an important role in the preoperative assessment of gliomas; however, the diagnostic performance of histogram-derived parameters from mono-, bi-, and stretched-exponential DWI models in the grading of gliomas has not been fully investigated. Therefore, we compared these models' ability to differentiate between high-grade and low-grade gliomas.

Methods: This retrospective study included 22 patients with diffuse gliomas (age, 23-74 years; 12 males; 11 high-grade and 11 low-grade gliomas) who underwent preoperative 3 T-magnetic resonance imaging from October 2014 to August 2019. The apparent diffusion coefficient was calculated from the mono-exponential model. Using 13 b-values, the true-diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction were obtained from the bi-exponential model, and the distributed-diffusion coefficient and heterogeneity index were obtained from the stretched-exponential model. Region-of-interests were drawn on each imaging parameter map for subsequent histogram analyses.

Results: The skewness of the apparent diffusion, true-diffusion, and distributed-diffusion coefficients was significantly higher in high-grade than in low-grade gliomas (0.67 ± 0.67 vs. - 0.18 ± 0.63, 0.68 ± 0.74 vs. - 0.08 ± 0.66, 0.63 ± 0.72 vs. - 0.15 ± 0.73; P = 0.0066, 0.0192, and 0.0128, respectively). The 10th percentile of the heterogeneity index was significantly lower (0.77 ± 0.08 vs. 0.88 ± 0.04; P = 0.0004), and the 90th percentile of the perfusion fraction was significantly higher (12.64 ± 3.44 vs. 7.14 ± 1.70%: P < 0.0001), in high-grade than in low-grade gliomas. The combination of the 10th percentile of the true-diffusion coefficient and 90th percentile of the perfusion fraction showed the best area under the receiver operating characteristic curve (0.96).

Conclusion: The bi-exponential model exhibited the best diagnostic performance for differentiating high-grade from low-grade gliomas.

Citing Articles

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