How to evaluate perfusion imaging in post-treatment glioma: a comparison of three different analysis methods.
Dynamic susceptibility contrast
Glioma
Perfusion weighted magnetic resonance imaging
Treatment-related abnormality
Tumor progression
Volume of interest
Journal
Neuroradiology
ISSN: 1432-1920
Titre abrégé: Neuroradiology
Pays: Germany
ID NLM: 1302751
Informations de publication
Date de publication:
08 May 2024
08 May 2024
Historique:
received:
16
11
2023
accepted:
01
05
2024
medline:
8
5
2024
pubmed:
8
5
2024
entrez:
7
5
2024
Statut:
aheadofprint
Résumé
Dynamic susceptibility contrast (DSC) perfusion weighted (PW)-MRI can aid in differentiating treatment related abnormalities (TRA) from tumor progression (TP) in post-treatment glioma patients. Common methods, like the 'hot spot', or visual approach suffer from oversimplification and subjectivity. Using perfusion of the complete lesion potentially offers an objective and accurate alternative. This study aims to compare the diagnostic value and assess the subjectivity of these techniques. 50 Glioma patients with enhancing lesions post-surgery and chemo-radiotherapy were retrospectively included. Outcome was determined by clinical/radiological follow-up or biopsy. Imaging analysis used the 'hot spot', volume of interest (VOI) and visual approach. Diagnostic accuracy was compared using receiving operator characteristics (ROC) curves for the VOI and 'hot spot' approach, visual assessment was analysed with contingency tables. Inter-operator agreement was determined with Cohens kappa and intra-class coefficient (ICC). 29 Patients suffered from TP, 21 had TRA. The visual assessment showed poor to substantial inter-operator agreement (κ = -0.72 - 0.68). Reliability of the 'hot spot' placement was excellent (ICC = 0.89), while reference placement was variable (ICC = 0.54). The area under the ROC (AUROC) of the mean- and maximum relative cerebral blood volume (rCBV) (VOI-analysis) were 0.82 and 0.72, while the rCBV-ratio ('hot spot' analysis) was 0.69. The VOI-analysis had a more balanced sensitivity and specificity compared to visual assessment. VOI analysis of DSC PW-MRI data holds greater diagnostic accuracy in single-moment differentiation of TP and TRA than 'hot spot' or visual analysis. This study underlines the subjectivity of visual placement and assessment.
Identifiants
pubmed: 38714545
doi: 10.1007/s00234-024-03374-3
pii: 10.1007/s00234-024-03374-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
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