Histogram analysis of diffusion kurtosis imaging estimates for in vivo assessment of 2016 WHO glioma grades: A cross-sectional observational study. Issue 95 (October 2017)

• Record Type: Journal Article
• Authors: Hempel, Johann-Martin; Schittenhelm, Jens; Brendle, Cornelia; Bender, Benjamin; Bier, Georg; Skardelly, Marco; Tabatabai, Ghazaleh; Castaneda Vega, Salvador; Ernemann, Ulrike; Klose, Uwe
• Is Part Of: European journal of radiology. Issue 95(2017)
• Page Start: 202
• Page End: 211
• Publication Date: 2017-10
• Subjects: 1p/19q LOH chromosome 1p/19q loss of heterozygosity -- 2016 CNS WHO 2016 World Health Organization classification (revised 4th edition) of tumors of the central nervous system -- ADC apparent diffusion coefficient -- AKC apparent excess kurtosis coefficient -- ALT alternative lengthening of telomeres phenotype -- ANOVA one-way analysis of variance -- AS astrocytoma -- AS2 diffuse astrocytoma -- AS3 anaplastic astrocytoma -- ATRX alpha-thalassemia/mental retardation syndrome X-linked -- AUC area under the curve -- DKI diffusion kurtosis imaging -- DTI diffusion tensor imaging -- FLAIR fluid attenuated inversion recovery -- GBM glioblastoma -- ICC intra-class correlation coefficient -- IDH1/2 isocitrate-dehydrogenase 1/2 mutation -- IDHmut IDH-mutated -- IDHwt IDH wild type -- MD mean diffusivity -- MK mean kurtosis -- MPRAGE magnetization prepared rapid acquisition gradient echo -- OD1p/19q-LOH 1p/19q-confirmed oligodendroglioma -- OD2 diffuse oligodendroglioma -- OD3 anaplastic oligodendroglioma -- ROC receiver operating characteristic -- TE time of echo -- TR time of repetition -- VOI volume of interest; Diffusion kurtosis imaging -- Non-Gaussian diffusion -- Glioma -- Grading -- Integrated diagnosis -- 2016 CNS WHO -- Histogram analysis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2017.08.008
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To assess the diagnostic performance of histogram analysis of diffusion kurtosis imaging (DKI) maps for in vivo assessment of the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 CNS WHO) integrated glioma grades. Materials and methods: Seventy-seven patients with histopathologically-confirmed glioma who provided written informed consent were retrospectively assessed between 01/2014 and 03/2017 from a prospective trial approved by the local institutional review board. Ten histogram parameters of mean kurtosis (MK) and mean diffusivity (MD) metrics from DKI were independently assessed by two blinded physicians from a volume of interest around the entire solid tumor. One-way ANOVA was used to compare MK and MD histogram parameter values between 2016 CNS WHO-based tumor grades. Receiver operating characteristic analysis was performed on MK and MD histogram parameters for significant results. Results: The 25th, 50th, 75th, and 90th percentiles of MK and average MK showed significant differences between IDH1/2wild-type gliomas, IDH1/2mutated gliomas, and oligodendrogliomas with chromosome 1p/19q loss of heterozygosity and IDH1/2mutation (p < 0.001). The 50th, 75th, and 90th percentiles showed a slightly higher diagnostic performance (area under the curve (AUC) range; 0.868–0.991) than average MK (AUC range; 0.855–0.988) in classifying glioma according to the integrated approach of 2016 CNS WHO. Conclusions: Histogram analysis of DKI can stratify gliomas according to the integrated approach of 2016 CNS WHO. The 50th (median), 75th, and the 90th percentiles showed the highest diagnostic performance. However, the average MK is also robust and feasible in routine clinical practice.