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Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach

  • Diagnostic Neuroradiology
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Abstract

Purpose

According to the revised World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) of 2016, oligodendrogliomas are now defined primarily by a specific molecular signature (presence of IDH mutation and 1p19q codeletion). The purpose of our study was to assess the value of dynamic susceptibility contrast MR imaging (DSC-MRI) and diffusion-weighted imaging (DWI) to characterize oligodendrogliomas and to distinguish them from astrocytomas.

Methods

Seventy-one adult patients with untreated WHO grade II and grade III diffuse infiltrating gliomas and known 1p/19q codeletion status were retrospectively identified and analyzed using relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) maps based on whole-tumor volume histograms. The Mann-Whitney U test and logistic regression were used to assess the ability of rCBV and ADC to differentiate between oligodendrogliomas and astrocytomas both independently, but also related to the WHO grade. Prediction performance was evaluated in leave-one-out cross-validation (LOOCV).

Results

Oligodendrogliomas showed significantly higher microvascularity (higher rCBVMean ≥ 0.80, p = 0.013) and higher vascular heterogeneity (lower rCBVPeak ≤ 0.044, p = 0.015) than astrocytomas. Diffuse gliomas with higher cellular density (lower ADCMean ≤ 1094 × 10−6 mm2/s, p = 0.009) were more likely to be oligodendrogliomas than astrocytomas. Histogram analysis of rCBV and ADC was able to differentiate between diffuse astrocytomas (WHO grade II) and anaplastic astrocytomas (WHO grade III).

Conclusion

Histogram-derived rCBV and ADC parameter may be used as biomarkers for identification of oligodendrogliomas and may help characterize diffuse gliomas based upon their genetic characteristics.

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Funding

This work was funded by the Southeastern Norway Regional Health Authority Extended Career Grants 2017073, 2013069 (KEE), the Research Council of Norway Grant ES435705 (KEE), Deutsche Forschungsgemeinschaft/Germany (DFG PA930/9, DFG PA930/12) (JP), the Leibniz Society/Germany (SAW-2015-IPB-2) (JP), HelseSØ/Norway (2016062) (JP), Norsk forskningsrådet/Norway (247179 NeuroGeM, 251290 FRIMEDIO, 260786 PROP-AD) (JP) and Horizon 2020/European Union (643417 (PROP-AD) (JP).

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Authors and Affiliations

  1. Department of Radiology, Oslo University Hospital—Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway

    Anna Latysheva, John K. Hald & Andrés Server

  2. Department of Diagnostic Physics, Oslo University Hospital—Rikshospitalet, Oslo, Norway

    Kyrre Eeg Emblem

  3. Department of Oncology, Oslo University Hospital—Radiumhospitalet, Oslo, Norway

    Petter Brandal

  4. Department of Neurosurgery, Oslo University Hospital—Rikshospitalet, Oslo, Norway

    Einar Osland Vik-Mo

  5. Faculty of Medicine, University of Oslo, Oslo, Norway

    Einar Osland Vik-Mo

  6. Department of Neuro-/Pathology, Translational Neurodegeneration Research and Neuropathology Lab, University of Oslo and Oslo University Hospital, Oslo, Norway

    Jens Pahnke

  7. University of Lübeck, LIED, Lübeck, Germany

    Jens Pahnke

  8. Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    Kjetil Røysland

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  1. Anna Latysheva
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Correspondence to Anna Latysheva.

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KEE has intellectual property rights with NordicNeuroLaB, Bergen Oslo.

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Latysheva, A., Emblem, K.E., Brandal, P. et al. Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach. Neuroradiology 61, 545–555 (2019). https://doi.org/10.1007/s00234-019-02173-5

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  • DOI: https://doi.org/10.1007/s00234-019-02173-5

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