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Neuroradiology
Published in: Neuroradiology 9/2006

01-09-2006 | Diagnostic Neuroradiology

Multiparametric 3T MR approach to the assessment of cerebral gliomas: tumor extent and malignancy

Authors: Alfonso Di Costanzo, Tommaso Scarabino, Francesca Trojsi, Giuseppe M. Giannatempo, Teresa Popolizio, Domenico Catapano, Simona Bonavita, Nicola Maggialetti, Michela Tosetti, Ugo Salvolini, Vincenzo A. d’Angelo, Giocchino Tedeschi

Published in: Neuroradiology | Issue 9/2006

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Abstract

Introduction

Contrast-enhanced MR imaging is the method of choice for routine assessment of brain tumors, but it has limited sensitivity and specificity. We verified if the addition of metabolic, diffusion and hemodynamic information improved the definition of glioma extent and grade.

Methods

Thirty-one patients with cerebral gliomas (21 high- and 10 low-grade) underwent conventional MR imaging, proton MR spectroscopic imaging (1H-MRSI), diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI) at 3 Tesla, before undergoing surgery and histological confirmation. Normalized metabolite signals, including choline (Cho), N-acetylaspartate (NAA), creatine and lactate/lipids, were obtained by 1H-MRSI; apparent diffusion coefficient (ADC) by DWI; and relative cerebral blood volume (rCBV) by PWI.

Results

Perienhancing areas with abnormal MR signal showed 3 multiparametric patterns: “tumor”, with abnormal Cho/NAA ratio, lower ADC and higher rCBV; “edema”, with normal Cho/NAA ratio, higher ADC and lower rCBV; and “tumor/edema”, with abnormal Cho/NAA ratio and intermediate ADC and rCBV. Perienhancing areas with normal MR signal showed 2 multiparametric patterns: “infiltrated”, with high Cho and/or abnormal Cho/NAA ratio; and “normal”, with normal spectra. Stepwise discriminant analysis showed that the better classification accuracy of perienhancing areas was achieved when regarding all MR variables, while 1H-MRSI variables and rCBV better differentiated high- from low-grade gliomas.

Conclusion

Multiparametric MR assessment of gliomas, based on 1H-MRSI, PWI and DWI, discriminates infiltrating tumor from surrounding vasogenic edema or normal tissues, and high- from low-grade gliomas. This approach may provide useful information for guiding stereotactic biopsies, surgical resection and radiation treatment.
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Metadata
Title
Multiparametric 3T MR approach to the assessment of cerebral gliomas: tumor extent and malignancy
Authors
Alfonso Di Costanzo
Tommaso Scarabino
Francesca Trojsi
Giuseppe M. Giannatempo
Teresa Popolizio
Domenico Catapano
Simona Bonavita
Nicola Maggialetti
Michela Tosetti
Ugo Salvolini
Vincenzo A. d’Angelo
Giocchino Tedeschi
Publication date
01-09-2006
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 9/2006
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-006-0102-3

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