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Published in: Clinical Neuroradiology 3/2018

01-09-2018 | Original Article

Glioma Grading and Determination of IDH Mutation Status and ATRX loss by DCE and ASL Perfusion

Authors: Cornelia Brendle, Johann-Martin Hempel, Jens Schittenhelm, Marco Skardelly, Ghazaleh Tabatabai, Benjamin Bender, Ulrike Ernemann, Uwe Klose

Published in: Clinical Neuroradiology | Issue 3/2018

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Abstract

Purpose

To evaluate arterial spin labeling (ASL) perfusion and dynamic contrast-enhanced (DCE) perfusion in glioma grading according to the previous WHO classification of 2007, as well as concerning isocitrate dehydrogenase (IDH) mutation status and ATRX expression as required by the new WHO 2016 brain tumor classification.

Methods

The mean values of Ktrans, Kep, Ve, and Vp by DCE perfusion, and cerebral blood flow (CBF) by ASL perfusion were assessed retrospectively in 40 patients with initial glioma diagnosis. Perfusion parameters were correlated and compared concerning glioma grading, IDH mutation status and ATRX expression.

Results

The DCE and ASL perfusion parameters showed merely moderate correlation. The Ktrans, Ve, and CBF by DCE perfusion were different in low-grade and high-grade gliomas (p = 0.0018, p < 0.0001, and p = 0.0038, respectively). Ve was useful in distinguishing high-grade from low-grade gliomas (p = 0.024, sensitivity = 1.00, specificity = 0.80). CBF by ASL perfusion enabled discrimination of astrocytomas with and without IDH mutation (p = 0.014, sensitivity = 0.75, specificity = 0.88) and showed a trend for the discrimination of astrocytomas with IDH mutation from oligodendrogliomas (p = 0.074).

Conclusion

In conclusion, DCE and ASL perfusion are complementary in the differentiation of gliomas. The discrimination of low- and high-grade gliomas is possible by the DCE perfusion parameter Ve, while ASL perfusion shows potential for the differentiation of the IDH and ATRX mutation status of gliomas following the new WHO classification 2016. Both perfusion techniques might represent different aspects of brain tumor perfusion.
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Metadata
Title
Glioma Grading and Determination of IDH Mutation Status and ATRX loss by DCE and ASL Perfusion
Authors
Cornelia Brendle
Johann-Martin Hempel
Jens Schittenhelm
Marco Skardelly
Ghazaleh Tabatabai
Benjamin Bender
Ulrike Ernemann
Uwe Klose
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 3/2018
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0590-z

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