Article Figures & Data
Figures
- Fig 1.
Images showing an example of determination of the TBF (A), ADC (B and C), and necrosis area (D and E). To determine absolute tumor blood flow, we placed the ROI in the enhancing lesion (A, black circle). Relative TBF was obtained by normalizing the aTBF by a blood flow measurement from the reference region (white circle). For ADC measurements, circular ROIs (C, black circles) were placed on ADC maps within the area that corresponded to the enhancing area on postcontrast T1WI, and the mean ADC value was obtained for each ROI. The lowest mean ADC value within all ROIs was determined as the minimum ADC. Regions with relatively low ADC were targeted. D and E, The largest cross-sectional necrosis area (red) and the percentage of the nonenhancing area inside the largest cross-sectional enhancing lesion were identified by manually outlining both the inside (red) and outside (yellow) enhancing contour to determine the NECarea. The enhancing area was carefully determined with reference to both pre- and postcontrast T1WI.
- Fig 2.
Plots of aTBF (A), rTBF (B), ADCminimum (C), ADCmean (D), NECarea (E), and %NEC (F) in patients with IDH1w and IDH1m. The aTBF, rTBF, NECarea, and %NEC were significantly higher in patients with IDH1w compared with those with IDH1m (P < .05 each). In contrast, no significant difference was found in the ADCminimum and ADCmean.
- Fig 3.
Receiver operating characteristic curves for discrimination between patients with IDH1w and those with IDH1m with the parameters aTBF, rTBF, NECarea, and %NEC. The AUC was significantly higher with the combination of all parameters than with NECarea or %NEC alone (P < .05).
- Fig 4.
Bland-Altman plots showing the interobserver variability of the differences versus average of aTBF (A) and rTBF (B) values. Dashed lines represent the 95% limits of agreement.
- Fig 5.
Contrast-enhanced T1WI (A), ADC map derived from DWI (B), and TBF map derived from ASL (C) of a 73-year-old woman with IDH1w. High aTBF (96.2 mL/100 g/min) and rTBF (2.78) were demonstrated in the enhancing tumor. The tumor also showed a high NECarea (518 mm2) and %NEC (44.2).
- Fig 6.
Contrast-enhanced T1WI (A), ADC map derived from DWI (B), and TBF map derived from ASL (C) of a 62-year-old woman with IDH1m. ASL perfusion demonstrated a relatively low aTBF (31.6 mL/100 g/min) and rTBF (1.05) in the enhancing tumor. The tumor also showed a low NECarea (30 mm2) and %NEC (4.14).
Tables
Comparison between 6 parameters and MGMT methylation status
Methylated Unmethylated P Value aTBF (mL/100 g/min) 100.4 ± 1.13 (n = 19) 99.4 ± 55.4 (n = 15) .96 rTBF 2.54 ± 1.31 (n = 19) 2.35 ± 0.81 (n = 15) .62 ADCminimum (×103mm2/s) 0.88 ± 0.19 (n = 24) 0.84 ± 0.20 (n = 21) .57 ADCmean (×103mm2/s) 0.97 ± 0.19 (n = 24) 0.96 ± 0.21 (n = 21) .92 NECarea (mm2) 503 ± 424 (n = 25) 621 ± 430 (n = 21) .36 %NEC 37.3 ± 21.1 (n = 25) 38.6 ± 22.7 (n = 21) .85
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