Non-invasive assessment of glioma microstructure using VERDICT MRI: correlation with histology.

Purpose: This prospective study evaluated the use of vascular, extracellular and restricted diffusion for cytometry in tumours (VERDICT) MRI to investigate the tissue microstructure in glioma. VERDICT-derived parameters were correlated with both histological features and tumour subtype and were also...

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Published in:European Radiology Vol. 29; no. 10; pp. 5559 - 5567
Main Authors: Zaccagna, Fulvio, Riemer, Frank, Priest, Andrew N., McLean, Mary A., Allinson, Kieren, Grist, James T., Dragos, Carmen, Matys, Tomasz, Gillard, Jonathan H., Watts, Colin, Price, Stephen J., Graves, Martin J., Gallagher, Ferdia A.
Format: diagnostic images pictorial research tables/charts Journal Article
Published: Springer Nature Oct2019
Online Access:View this record in EBSCOhost
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      dt: Oct2019
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      pub: Springer Nature
      place: New York, New York
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        atl: Non-invasive assessment of glioma microstructure using VERDICT MRI: correlation with histology.
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          Zaccagna, Fulvio
          Riemer, Frank
          Priest, Andrew N.
          McLean, Mary A.
          Allinson, Kieren
          Grist, James T.
          Dragos, Carmen
          Matys, Tomasz
          Gillard, Jonathan H.
          Watts, Colin
          Price, Stephen J.
          Graves, Martin J.
          Gallagher, Ferdia A.
        affil: Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, CB2 0QQ, Cambridge, UK
      sug:
        subj:
          Glioma
          Brain Neoplasms
          Glioma Pathology
          Middle Age
          Male
          Adult
          Pilot Studies
          Prospective Studies
          Reproducibility of Results
          Neoplasm Grading
          Aged
          Magnetic Resonance Angiography Methods
          Magnetic Resonance Imaging Methods
          Young Adult
          Female
          Brain Neoplasms Pathology
          Human
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: This prospective study evaluated the use of vascular, extracellular and restricted diffusion for cytometry in tumours (VERDICT) MRI to investigate the tissue microstructure in glioma. VERDICT-derived parameters were correlated with both histological features and tumour subtype and were also used to explore the peritumoural region.Methods: Fourteen consecutive treatment-naïve patients (43.5 years ± 15.1 years, six males, eight females) with suspected glioma underwent diffusion-weighted imaging including VERDICT modelling. Tumour cell radius and intracellular and combined extracellular/vascular volumes were estimated using a framework based on linearisation and convex optimisation. An experienced neuroradiologist outlined the peritumoural oedema, enhancing tumour and necrosis on T2-weighted imaging and contrast-enhanced T1-weighted imaging. The same regions of interest were applied to the co-registered VERDICT maps to calculate the microstructure parameters. Pathology sections were analysed with semi-automated software to measure cellularity and cell size.Results: VERDICT parameters were successfully calculated in all patients. The imaging-derived results showed a larger intracellular volume fraction in high-grade glioma compared to low-grade glioma (0.13 ± 0.07 vs. 0.08 ± 0.02, respectively; p = 0.05) and a trend towards a smaller extracellular/vascular volume fraction (0.88 ± 0.07 vs. 0.92 ± 0.04, respectively; p = 0.10). The conventional apparent diffusion coefficient was higher in low-grade gliomas compared to high-grade gliomas, but this difference was not statistically significant (1.22 ± 0.13 × 10-3 mm2/s vs. 0.98 ± 0.38 × 10-3 mm2/s, respectively; p = 0.18).Conclusion: This feasibility study demonstrated that VERDICT MRI can be used to explore the tissue microstructure of glioma using an abbreviated protocol. The VERDICT parameters of tissue structure correlated with those derived on histology. The method shows promise as a potential test for diagnostic stratification and treatment response monitoring in the future.Key Points: • VERDICT MRI is an advanced diffusion technique which has been correlated with histopathological findings obtained at surgery from patients with glioma in this study. • The intracellular volume fraction measured with VERDICT was larger in high-grade tumours compared to that in low-grade tumours. • The results were complementary to measurements from conventional diffusion-weighted imaging, and the technique could be performed in a clinically feasible timescale.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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