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Comparison of T1 mapping and fixed T1 method for dynamic contrast-enhanced MRI perfusion in brain gliomas

  • G. M. Conte
  • L. Altabella
  • A. Castellano
  • V. Cuccarini
  • A. Bizzi
  • M. Grimaldi
  • A. Costa
  • M. Caulo
  • A. Falini
  • N. AnzaloneEmail author
Neuro

Abstract

Objectives

To compare dynamic contrast-enhanced MRI (DCE-MRI) data obtained using different prebolus T1 values in glioma grading and molecular profiling.

Methods

We retrospectively reviewed 83 cases of gliomas: 46 lower-grade gliomas (LGG; grades II and III) and 37 high-grade gliomas (HGG; grade IV). DCE-MRI maps of plasma volume fraction (Vp), extravascular-extracellular volume fraction (Ve), and tracer transfer constant from plasma to tissue (Ktrans) were obtained using a fixed T1 value of 1400 ms and a measured T1 obtained with variable flip angle (VFA). Tumour segmentations were performed and first-order histogram parameters were extracted from volumes of interest (VOIs) after co-registration with the perfusion maps. The two methods were compared using Wilcoxon matched-pairs signed-rank test and Bland-Altman analysis. Diagnostic accuracy was obtained and compared using ROC curve analysis and DeLong’s test.

Results

Perfusion parameters obtained with the fixed T1 value were significantly higher than those obtained with the VFA. As regards diagnostic accuracy, there were no significant differences between the two methods both for glioma grading and molecular classification, except for few parameters of both methods.

Conclusions

DCE-MRI data obtained with different prebolus T1 are not comparable and the definition of a prebolus T1 by T1 mapping is not mandatory since it does not improve the diagnostic accuracy of DCE-MRI.

Key Points

• DCE-MRI data obtained with different prebolus T1 are significantly different, thus not comparable.

• The definition of a prebolus T1 by T1 mapping is not mandatory since it does not improve the diagnostic accuracy of DCE-MRI for glioma grading.

• The use of a fixed T1 value represents a valid alternative to T1 mapping for DCE-MRI analysis.

Keywords

Magnetic resonance imaging Brain Glioma Perfusion imaging 

Abbreviations

HGG

High-grade gliomas

IDH

Isocitrate dehydrogenase

Ktrans

Tracer transfer constant from plasma to tissue

LGG

Lower-grade gliomas

Ve

Extravascular-extracellular volume fraction

VFA

Variable flip angle

Vp

Plasma volume fraction

Notes

Acknowledgements

The authors thank Marcello Cadioli and Antonella Iadanza for technical support, and Bradley J. Erickson for reviewing the article.

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Nicoletta Anzalone.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Nicoletta Anzalone is a member of the advisory board of Bracco; is a consultant for Bayer Healthcare; is on the speakers bureaus of Bayer Healthcare and Guerbet.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

All study subjects have been previously reported in: Anzalone N, Castellano A, Cadioli M, Conte GM, et al. Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images. Radiology, 2018.

Methodology

• retrospective

• diagnostic study

• multicentre study

Supplementary material

330_2019_6122_MOESM1_ESM.docx (2.2 mb)
ESM 1 (DOCX 2287 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Neuroradiology Unit and CERMACVita-Salute San Raffaele University and IRCCS San Raffaele Scientific InstituteMilanItaly
  2. 2.Neuroradiology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  3. 3.Department of RadiologyHumanitas Clinical and Research HospitalMilanItaly
  4. 4.Department of NeuroradiologyFondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoMilanItaly
  5. 5.Department of Neuroscience and Imaging and ITAB-Institute of Advanced Biomedical TechnologiesUniversity G. D’AnnunzioChietiItaly

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