Diagnostic Accuracy of Arterial Spin-Labeling, Dynamic Contrast-Enhanced, and DSC Perfusion Imaging in the Diagnosis of Recurrent High-Grade Gliomas: A Prospective Study
Diagnostic Accuracy of Arterial Spin-Labeling, Dynamic Contrast-Enhanced, and DSC Perfusion Imaging in the Diagnosis of Recurrent High-Grade Gliomas: A Prospective Study
复制标题
动脉自旋标记、动态对比增强和 DSC 灌注成像在诊断复发性高级别胶质瘤中的诊断准确性：一项前瞻性研究
DOI：
--
复制
发表时间：
2023
影响因子：
3.5
通讯作者：
G. Cron
中科院分区：
文献类型：
--
作者：
T.B. Nguyen;N. Zakhari;S. Velasco Sandoval;A. Guarnizo;M. Alexios Gulak;J. Woulfe;G. Jansen;R. Thornhill;N. Majtenyi;G. Cron
在鉴别新增强病灶的肿瘤复发与放射性坏死时，动脉自旋标记衍生CBF的诊断价值与DSC和动态对比增强衍生血容量的诊断价值相似。背景与目的：对于高级别胶质瘤患者，手术和放化疗后出现新的强化病变代表了诊断困境。我们假设MR灌注不加对比剂和加对比剂可以区分肿瘤复发和放射性坏死。材料和方法：在这项前瞻性研究中，我们进行了3种MR灌注方法：动脉自旋标记、DSC和动态对比增强。对于每个病变，我们测量了动脉自旋标记的CBF、未校正的相对CBV和DSC成像的泄漏校正的相对CBV。采用改进的Look-Locker反演恢复（MOLLI）技术，通过动态对比增强成像获得了T1和T1映射下的体积传递常数和等离子体体积。肿瘤复发或放射性坏死的诊断由再切除患者的组织病理学或未再切除患者的放射学随访确定。结果：26例32个病灶，肿瘤复发19例，放射性坏死13例。与放射性坏死相比，肿瘤复发病变的CBF （P = 0.033）、泄漏校正的相对CBV （P = 0.048）和MOLLI T1测图的血浆体积（P = 0.012）更高。为了区分肿瘤复发和放射性坏死，曲线下面积为0.81的CBF， 0.80血浆体积使用MOLLI T1作图，0.71的泄漏校正相对CBV。CBF与泄漏校正的相对CBV （rs = 0.54）、体积传递常数和血浆体积（0.50 < rs< 0.77）存在相关性，但与未校正的相对CBV不存在相关性（rs = 0.20, P = 0.29）。结论：在鉴别新发增强病灶的肿瘤复发与放射性坏死时，动脉自旋标记衍生CBF与DSC、动态对比增强衍生血容量的诊断价值相近。
In the differentiation of tumor recurrence from radiation necrosis in a newly enhancing lesion, the diagnostic value of arterial spin-labeling-derived CBF is similar to that of DSC and dynamic contrast-enhanced-derived blood volume. BACKGROUND AND PURPOSE: For patients with high-grade gliomas, the appearance of a new, enhancing lesion after surgery and chemoradiation represents a diagnostic dilemma. We hypothesized that MR perfusion without and with contrast can differentiate tumor recurrence from radiation necrosis. MATERIALS AND METHODS: In this prospective study, we performed 3 MR perfusion methods: arterial spin-labeling, DSC, and dynamic contrast enhancement. For each lesion, we measured CBF from arterial spin-labeling, uncorrected relative CBV, and leakage-corrected relative CBV from DSC imaging. The volume transfer constant and plasma volume were obtained from dynamic contrast-enhanced imaging without and with T1 mapping using modified Look-Locker inversion recovery (MOLLI). The diagnosis of tumor recurrence or radiation necrosis was determined by either histopathology for patients who underwent re-resection or radiologic follow-up for patients who did not have re-resection. RESULTS: There were 26 patients with 32 lesions, 19 lesions with tumor recurrence and 13 lesions with radiation necrosis. Compared with radiation necrosis, lesions with tumor recurrence had higher CBF (P = .033), leakage-corrected relative CBV (P = .048), and plasma volume using MOLLI T1 mapping (P = .012). For differentiating tumor recurrence from radiation necrosis, the areas under the curve were 0.81 for CBF, 0.80 for plasma volume using MOLLI T1 mapping, and 0.71 for leakage-corrected relative CBV. A correlation was found between CBF and leakage-corrected relative CBV (rs = 0.54), volume transfer constant, and plasma volume (0.50 < rs< 0.77) but not with uncorrected relative CBV (rs = 0.20, P = .29). CONCLUSIONS: In the differentiation of tumor recurrence from radiation necrosis in a newly enhancing lesion, the diagnostic value of arterial spin-labeling–derived CBF is similar to that of DSC and dynamic contrast-enhancement–derived blood volume.