Multiparametric Characterization of Grade 2 Glioma Subtypes Using Magnetic Resonance Spectroscopic, Perfusion, and Diffusion Imaging
Multiparametric Characterization of Grade 2 Glioma Subtypes Using Magnetic Resonance Spectroscopic, Perfusion, and Diffusion Imaging
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DOI：
10.1593/tlo.09178
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发表时间：
2009-12-01
影响因子：
5
通讯作者：
Nelson, Sarah J.
中科院分区：
文献类型：
--
作者：
Bian, Wei;Khayal, Inas S.;Nelson, Sarah J.
背景和目的：本研究的目的是从磁共振（MR）光谱，灌注和扩散成像的2级胶质瘤根据世界卫生组织的定量参数，并探讨这些多种成像方式如何有助于评估其组织学亚型和空间特征。材料和方法：回顾性研究了56例新诊断的2级胶质瘤（24例少突胶质细胞瘤，18例星形细胞瘤和14例少突星形细胞瘤）的MR波谱，灌注和扩散图像。对代谢物强度、相对脑血容量（rCBV）和表观弥散系数（ADC）进行统计学评价。研究结果：少突胶质细胞瘤和星形细胞瘤之间的第75百分位rCBV和中位数ADC值有显著差异（P < .0001），少突胶质细胞瘤和少突星形细胞瘤之间也有显著差异（P < .001）。Logistic回归分析确定第75百分位数rCBV和中位数ADC值是区分少突胶质细胞瘤与星形细胞瘤和少突星形细胞瘤的重要变量。代谢物强度的组间差异不显著，但与其他肿瘤亚型相比，少突胶质细胞瘤患者代谢异常的体积和最大值变化更大。结论：灌注和弥散成像提供定量MR参数，有助于区分2级少突胶质细胞瘤与2级星形细胞瘤和少突星形细胞瘤。患者之间代谢病变的幅度和空间范围的较大变化以及它们的值与其他成像参数不相关的事实表明，MR光谱成像可以提供有助于靶向治疗、评价残留疾病和评估对治疗的反应的补充信息。
BACKGROUND AND PURPOSE: The purpose of this study was to derive quantitative parameters from magnetic resonance (MR) spectroscopic, perfusion, and diffusion imaging of grade 2 gliomas according to the World Health Organization and to investigate how these multiple imaging modalities can contribute to evaluating their histologic subtypes and spatial characteristics. MATERIALS AND METHODS: MR spectroscopic, perfusion, and diffusion images from 56 patients with newly diagnosed grade 2 glioma (24 oligodendrogliomas, 18 astrocytomas, and 14 oligoastrocytomas) were retrospectively studied. Metabolite intensities, relative cerebral blood volume (rCBV), and apparent diffusion coefficient (ADC) were statistically evaluated. RESULTS: The 75th percentile rCBV and median ADC were significantly different between oligodendrogliomas and astrocytomas (P < .0001) and between oligodendrogliomas and oligoastrocytomas (P < .001). Logistic regression analysis identified both 75th percentile rCBV and median ADC as significant variables in the differentiation of oligodendrogliomas from astrocytomas and oligoastrocytomas. Group differences in metabolite intensities were not significant, but there was a much larger variation in the volumes and maximum values of metabolic abnormalities for patients with oligodendroglioma compared with the other tumor subtypes. CONCLUSIONS: Perfusion and diffusion imaging provide quantitative MR parameters that can help to differentiate grade 2 oligodendrogliomas from grade 2 astrocytomas and oligoastrocytomas. The large variations in the magnitude and spatial extent of the metabolic lesions between patients and the fact that their values are not correlated with the other imaging parameters indicate that MR spectroscopic imaging may provide complementary information that is helpful in targeting therapy, evaluating residual disease, and assessing response to therapy.