DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions.
Purpose: The presurgical discrimination of IDH-mutant astrocytoma grade 4 from IDH-wildtype glioblastoma is crucial for patient management, especially in younger adults, aiding in prognostic assessment, guiding molecular diagnostics and surgical planning, and identifying candidates for IDH-targeted...
| Publicado en: | Neuroradiology Vol. 66; no. 8; pp. 1267 - 1278 |
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| Autores principales: | , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178416293&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178416293 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: Aug2024 vid: 66 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 178416293 177645324 178416293 178416293 10.1007/s00234-024-03385-0 178416293 ppf: 1267 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions. aug: au: Pons-Escoda, Albert Naval-Baudin, Pablo Viveros, Mildred Flores-Casaperalta, Susanie Martinez-Zalacaín, Ignacio Plans, Gerard Vidal, Noemi Cos, Monica Majos, Carles affil: https://ror.org/00epner96 Radiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain sug: subj: Glioma Diagnosis Cerebral Blood Volume Magnetic Resonance Imaging Perfusion Imaging Neoplasm Grading Preoperative Care Human Male Female Adolescence Adult Middle Age Retrospective Design Record Review Descriptive Statistics Mann-Whitney U Test Glioma Pathology ROC Curve Brain Neoplasms Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: The presurgical discrimination of IDH-mutant astrocytoma grade 4 from IDH-wildtype glioblastoma is crucial for patient management, especially in younger adults, aiding in prognostic assessment, guiding molecular diagnostics and surgical planning, and identifying candidates for IDH-targeted trials. Despite its potential, the full capabilities of DSC-PWI remain underexplored. This research evaluates the differentiation ability of relative-cerebral-blood-volume (rCBV) percentile values for the enhancing and non-enhancing tumor regions compared to the more commonly used mean or maximum preselected rCBV values. Methods: This retrospective study, spanning 2016–2023, included patients under 55 years (age threshold based on World Health Organization recommendations) with grade 4 astrocytic tumors and known IDH status, who underwent presurgical MR with DSC-PWI. Enhancing and non-enhancing regions were 3D-segmented to calculate voxel-level rCBV, deriving mean, maximum, and percentile values. Statistical analyses were conducted using the Mann-Whitney U test and AUC-ROC. Results: The cohort consisted of 59 patients (mean age 46; 34 male): 11 astrocytoma-4 and 48 glioblastoma. While glioblastoma showed higher rCBV in enhancing regions, the differences were not significant. However, non-enhancing astrocytoma-4 regions displayed notably higher rCBV, particularly in lower percentiles. The 30th rCBV percentile for non-enhancing regions was 0.705 in astrocytoma-4, compared to 0.458 in glioblastoma (p = 0.001, AUC-ROC = 0.811), outperforming standard mean and maximum values. Conclusion: Employing an automated percentile-based approach for rCBV selection enhances differentiation capabilities, with non-enhancing regions providing more insightful data. Elevated rCBV in lower percentiles of non-enhancing astrocytoma-4 is the most distinguishable characteristic and may indicate lowly vascularized infiltrated edema, contrasting with glioblastoma's pure edema. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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