Applying Chemical Shift Images (in-phase/opposed Phased) for Differentiating Low-grade from High-grade Glioma and Comparison with Magnetic Resonance Spectroscopy

Overview

Journal Radiologie (Heidelb)

Specialty Radiology

Date 2024 Jul 8

PMID 38977491

Authors

Bita Abbasi

Afshar Ghamari Khameneh

Hadi Zareh Soltaniye

Gisoo Darban Hosseini Amirkhiz

Ehsan Karimi

Reza Akhavan

Affiliations

Soon will be listed here.

Abstract

Background: Grading gliomas is essential for treatment decisions and patient prognosis. In this study we evaluated the in-phase and out-of-phase sequences for distinguishing high-grade (HGG) from low-grade glioma (LGG) and the correlation with magnetic resonance spectroscopy (MRS) results.

Methods: This observational study comprised patients with brain tumors referred to our center for brain MRS. The gold standard for diagnosis was based on the World Health Organization (WHO) glioma classification. A standard tumor protocol was accomplished using a 1.5‑T MRS scanner. Before contrast medium administration, extra in- and out-phase sequences were acquired. Three 20-30-mm oval regions of interest (ROIs) were placed in the solid component and the signal loss ratio (SLR) was calculated with the following formula: SLR  = (SI  - SI ) / SI Correlations and comparisons between groups were made using the Pearson, chi-square and, independent samples t tests. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance. Statistical significance was set at p < 0.05.

Results: In total, 20 patients were included in the LGG and 13 were included in the HGG group. The mean SLR in the HGG and LGG groups was 3.66 ± 2.12 and 1.63 ± 1.86, respectively (p = 0.01). There was a statistically significant correlation between lipid lactate (0.48, p = 0.004) and free lipid (0.44, p = 0.009) concentrations on MRS with SLR.

Conclusions: The SLR is a simple, rapid, and noninvasive marker for differentiating between LGG and HGG. There is a significant correlation with both the concentration and presence of free lipid and lipid-lactate peaks in MRS.

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