PT  - JOURNAL ARTICLE
AU  - Nguyen, T.B.
AU  - Cron, G.O.
AU  - Perdrizet, K.
AU  - Bezzina, K.
AU  - Torres, C.H.
AU  - Chakraborty, S.
AU  - Woulfe, J.
AU  - Jansen, G.H.
AU  - Sinclair, J.
AU  - Thornhill, R.E.
AU  - Foottit, C.
AU  - Zanette, B.
AU  - Cameron, I.G.
TI  - Comparison of the Diagnostic Accuracy of DSC- and Dynamic Contrast-Enhanced MRI in the Preoperative Grading of Astrocytomas
AID  - 10.3174/ajnr.A4398
DP  - 2015 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2017--2022
VI  - 36
IP  - 11
4099  - http://www.ajnr.org/content/36/11/2017.short
4100  - http://www.ajnr.org/content/36/11/2017.full
SO  - Am. J. Neuroradiol.2015 Nov 01; 36
AB  - BACKGROUND AND PURPOSE: Dynamic contrast-enhanced MR imaging parameters can be biased by poor measurement of the vascular input function. We have compared the diagnostic accuracy of dynamic contrast-enhanced MR imaging by using a phase-derived vascular input function and “bookend” T1 measurements with DSC MR imaging for preoperative grading of astrocytomas.MATERIALS AND METHODS: This prospective study included 48 patients with a new pathologic diagnosis of an astrocytoma. Preoperative MR imaging was performed at 3T, which included 2 injections of 5-mL gadobutrol for dynamic contrast-enhanced and DSC MR imaging. During dynamic contrast-enhanced MR imaging, both magnitude and phase images were acquired to estimate plasma volume obtained from phase-derived vascular input function (Vp_Φ) and volume transfer constant obtained from phase-derived vascular input function (Ktrans_Φ) as well as plasma volume obtained from magnitude-derived vascular input function (Vp_SI) and volume transfer constant obtained from magnitude-derived vascular input function (Ktrans_SI). From DSC MR imaging, corrected relative CBV was computed. Four ROIs were placed over the solid part of the tumor, and the highest value among the ROIs was recorded. A Mann-Whitney U test was used to test for difference between grades. Diagnostic accuracy was assessed by using receiver operating characteristic analysis.RESULTS: Vp_ Φ and Ktrans_Φ values were lower for grade II compared with grade III astrocytomas (P < .05). Vp_SI and Ktrans_SI were not significantly different between grade II and grade III astrocytomas (P = .08–0.15). Relative CBV and dynamic contrast-enhanced MR imaging parameters except for Ktrans_SI were lower for grade III compared with grade IV (P ≤ .05). In differentiating low- and high-grade astrocytomas, we found no statistically significant difference in diagnostic accuracy between relative CBV and dynamic contrast-enhanced MR imaging parameters.CONCLUSIONS: In the preoperative grading of astrocytomas, the diagnostic accuracy of dynamic contrast-enhanced MR imaging parameters is similar to that of relative CBV.DCEdynamic contrast-enhancedKtrans_Φvolume transfer constant obtained from phase-derived vascular input functionKtrans_SIvolume transfer constant obtained from magnitude-derived vascular input functionrCBVrelative CBVSIsignal intensityVIFvascular input functionVpplasma volumeVp_Φplasma volume obtained from phase-derived vascular input functionVp_SIplasma volume obtained from magnitude-derived vascular input function