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Quantitative susceptibility mapping evaluation of glioma

  • Oncology
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European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To comprehensively evaluate the glioma using quantitative susceptibility mapping (QSM).

Materials and methods

Forty-two patients (18 women; mean age, 45 years) with pathologically confirmed gliomas were retrospectively included. All the patients underwent conventional and advanced MRI examinations (QSM, DWI, MRS, etc.). Five patients underwent paired QSM (pre- and post-enhancement). Four Visually Accessible Rembrandt Image (VASARI) features and intratumoural susceptibility signal (ITSS) were observed. Three ROIs each were manually drawn separately in the tumour parenchyma with relatively high and low magnetic susceptibility. The association between the tumour’s magnetic susceptibility and other MRI parameters was also analysed.

Results

Morphologically, gliomas with heterogeneous ITSS were more similar to high-grade gliomas (p = 0.006, AUC: 0.72, sensitivity: 70%, and specificity: 73%). Heterogeneous ITSS was significantly associated with tumour haemorrhage, necrosis, diffusion restriction, and avid enhancement but did not change between pre- and post-enhanced QSM. Quantitatively, tumour parenchyma magnetic susceptibility had limited value in grading gliomas and identifying IDH mutation status, whereas the relatively low magnetic susceptibility of the tumour parenchyma helped identify oligodendrogliomas in IDH mutated gliomas (AUC = 0.78) with high specificity (100%). The relatively high tumour magnetic susceptibility significantly increased after enhancement (p = 0.039). Additionally, we found that the magnetic susceptibility of the tumour parenchyma was significantly correlated with ADC (r = 0.61) and Cho/NAA (r = 0.40).

Conclusions

QSM is a promising candidate for the comprehensive evaluation of gliomas, except for IDH mutation status. The magnetic susceptibility of tumour parenchyma may be affected by tumour cell proliferation.

Key Points

• Morphologically, gliomas with a heterogeneous intratumoural susceptibility signal (ITSS) are more similar to high-grade gliomas (p = 0.006; AUC, 0.72; sensitivity, 70%; and specificity, 73%). Heterogeneous ITSS was significantly associated with tumour haemorrhage, necrosis, diffusion restriction, and avid enhancement but did not change between pre- and post-enhanced QSM.

• Tumour parenchyma’s relatively low magnetic susceptibility helped identify oligodendroglioma with high specificity.

• Tumour parenchyma magnetic susceptibility was significantly correlated with ADC (r = 0.61) and Cho/NAA (r = 0.40).

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Abbreviations

ADC:

Apparent diffusion coefficient

ASL:

Arterial spin labelling

Cho:

Choline

DCE-MRI:

Dynamic contrast-enhanced MRI

DWI:

Diffusion-weighted imaging

HGGs:

High-grade gliomas

ITSS:

Intratumoural susceptibility signal

Kep:

Rate constant

Ktrans :

Transfer constant

LGGs:

Low-grade gliomas

MRS:

Magnetic resonance spectrum

NAA:

N-acetylaspartate

QSM:

Quantitative susceptibility mapping

relCBV:

Relative cerebral blood volume

SWI:

Susceptibility-weighted imaging

VASARI:

Visually Accessible Rembrandt Image

Ve:

Extravascular-extracellular space volume fraction

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Acknowledgements

This study was supported by the Guangdong Basic and Applied Basic Research Foundation, China, and the National Natural Science Foundation.

Funding

This study has received funding from the Guangdong Basic and Applied Basic Research Foundation, China (No.2020A1515011436, 2021A1515012279, 2022A1515011264), and the National Natural Science Foundation (NSFC 82172015).

Author information

Author notes

  1. Shanmei Zeng, Hui Ma, and Dingxiang Xie contributed equally as first authors.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangdong, 510080, Guangzhou, People’s Republic of China

    Shanmei Zeng, Hui Ma, Dingxiang Xie, Yingqian Huang, Wenting Zeng, Nengjin Zhu, Zuliwei Ma, Zhiyun Yang, Jianping Chu & Jing Zhao

  2. Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou, Guangdong, People’s Republic of China

    Mengzhu Wang

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Corresponding authors

Correspondence to Jianping Chu or Jing Zhao.

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Guarantor

The scientific guarantor of this publication is Jing Zhao. Jianping Chu is a co-guarantor.

Conflict of interest

One of the authors (Mengzhu Wang) is an employee of Siemens Healthineers (Guangzhou, China). This author was not involved in data collection and/or management in any way that would influence the study. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because of the retrospective nature of this study.

Ethical approval

The Research Ethics Committee of the First Affiliated Hospital of Sun Yat-Sen University has approved this study (No. [2021]209).

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Zeng, S., Ma, H., Xie, D. et al. Quantitative susceptibility mapping evaluation of glioma. Eur Radiol 33, 6636–6647 (2023). https://doi.org/10.1007/s00330-023-09647-4

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