Differentiating low-grade from high-grade intracranial ependymomas: Comparison of dynamic contrast-enhanced MRI and diffusion-weighted imaging Journal Article
| Authors: | Arevalo-Perez, J.; Yllera-Contreras, E.; Peck, K. K.; Hatzoglou, V.; Yildirim, O.; Rosenblum, M. K.; Holodny, A. I. |
| Article Title: | Differentiating low-grade from high-grade intracranial ependymomas: Comparison of dynamic contrast-enhanced MRI and diffusion-weighted imaging |
| Abstract: | BACKGROUND AND PURPOSE: The aim of this study was to determine the diagnostic value of fractional plasma volume derived from dynamic contrast-enhanced perfusion MR imaging versus ADC, obtained from DWI in differentiating between grade 2 (low-grade) and grade 3 (high-grade) intracranial ependymomas. MATERIALS AND METHODS: A hospital database was created for the period from January 2013 through June 2022, including patients with histologically-proved ependymoma diagnosis with available dynamic contrast-enhanced MR imaging. Both dynamic contrast-enhanced perfusion and DWI were performed on each patient using 1.5T and 3T scanners. Fractional plasma volume maps and ADC maps were calculated. ROIs were defined by a senior neuroradiologist manually by including the enhancing tumor on every section and conforming a VOI to obtain the maximum value of fractional plasma volume (Vpmax) and the minimum value of ADC (ADCmin). A Mann-Whitney U test at a significance level of corrected P = .01 was used to evaluate the differences. Additionally, receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of Vpmax and ADCmin values. RESULTS: A total of 20 patients with ependymomas (10 grade 2 tumors and 10 grade 3 tumors) were included. Vpmax values for grade 3 ependymomas were significantly higher (P < .002) than those for grade 2. ADCmin values were overall lower in high-grade lesions. However, no statistically significant differences were found (P = .12114). CONCLUSIONS: As a dynamic contrast-enhanced perfusion MR imaging metric, fractional plasma volume can be used as an indicator to differentiate grade 2 and grade 3 ependymomas. Dynamic contrast-enhanced perfusion MR imaging plays an important role with high diagnostic value in differentiating low- and high-grade ependymoma. © 2024 by American Journal of Neuroradiology. |
| Keywords: | adolescent; adult; child; aged; middle aged; retrospective studies; young adult; comparative study; nuclear magnetic resonance imaging; brain tumor; brain neoplasms; magnetic resonance imaging; cancer grading; sensitivity and specificity; diagnosis, differential; differential diagnosis; pathology; diagnostic imaging; retrospective study; contrast medium; contrast media; ependymoma; diffusion weighted imaging; diffusion magnetic resonance imaging; procedures; neoplasm grading; humans; human; male; female |
| Journal Title: | American Journal of Neuroradiology |
| Volume: | 45 |
| Issue: | 7 |
| ISSN: | 0195-6108 |
| Publisher: | American Society of Neuroradiology |
| Date Published: | 2024-07-01 |
| Start Page: | 927 |
| End Page: | 933 |
| Language: | English |
| DOI: | 10.3174/ajnr.A8226 |
| PUBMED: | 38782589 |
| PROVIDER: | scopus |
| PMCID: | PMC11286012 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Julio Arevalo-Perez -- Source: Scopus |
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