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Neuroradiology
Published in: Neuroradiology 4/2018

01-04-2018 | Paediatric Neuroradiology

Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI perfusion

Authors: Giovanni Morana, Domenico Tortora, Serena Staglianò, Paolo Nozza, Samantha Mascelli, Mariasavina Severino, Gianluca Piatelli, Alessandro Consales, Maarten Lequin, Maria Luisa Garrè, Andrea Rossi

Published in: Neuroradiology | Issue 4/2018

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Abstract

Purpose

The aim of this study was to compare arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) MRI perfusion with respect to diagnostic performance in tumor grading in pediatric patients with low- and high-grade astrocytic tumors (AT).

Methods

We retrospectively analyzed 37 children with histologically proven treatment naive low- and high-grade AT who underwent concomitant pre-operative ASL and DSC MRI perfusion. Studies were performed on a 1.5 T scanner, and a pulsed technique was used for ASL. DSC data were post-processed with a leakage correction software. Normalization of tumor perfusion parameters was performed with contralateral normal appearing gray matter. Normalized cerebral blood volume (nCBV) values in the most perfused area of each neoplasm were compared with normalized DSC-derived cerebral blood flow (nDSC-CBF) and ASL-derived cerebral blood flow (nASL-CBF) data, and correlated with WHO tumor grade. Statistics included Pearson’s chi-square and Mann-Whitney U tests, Spearman’s rank correlation, and receiver operating characteristic (ROC) analysis.

Results

A significant correlation was demonstrated between DSC and ASL data (p < 0.001). Significant differences in terms of DSC and ASL data were found between low- and high-grade AT (p < 0.001). ROC analysis demonstrated similar performances between all parameters in predicting tumor grade (nCBV: AUC 0.96, p < 0.001; nDSC-CBF: AUC 0.98, p < 0.001; nASL-CBF: AUC 0.96, p < 0.001).

Conclusions

Normalized pulsed ASL performed with a 1.5 T scanner provides comparable results to DSC MRI perfusion in pediatric AT and may allow distinction between high- and low-grade AT.
Literature
1.
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed
2.
Jones DT, Mulholland SA, Pearson DM, Malley DS, Openshaw SW, Lambert SR et al (2011) Adult grade II diffuse astrocytomas are genetically distinct from and more aggressive than their paediatric counterparts. Acta Neuropathol 121:753–761CrossRefPubMed
3.
Paugh BS, Qu C, Jones C, Liu Z, Adamowicz-Brice M, Zhang J, Bax DA, Coyle B, Barrow J, Hargrave D, Lowe J, Gajjar A, Zhao W, Broniscer A, Ellison DW, Grundy RG, Baker SJ (2010) Integrated molecular genetic profiling of pediatric high-grade gliomas reveals key differences with the adult disease. J Clin Oncol 28:3061–3068CrossRefPubMedPubMedCentral
4.
5.
Sturm D, Pfister SM, Jones DTW (2017) Pediatric gliomas: current concepts on diagnosis, biology, and clinical management. J Clin Oncol 35:2370–2377CrossRefPubMed
6.
Chiang JC, Ellison DW (2017) Molecular pathology of paediatric central nervous system tumours. J Pathol 241:159–172CrossRefPubMed
7.
Griffith B, Jain R (2015) Perfusion imaging in neuro-oncology: basic techniques and clinical applications. Radiol Clin North Am 53:497–511CrossRefPubMed
8.
Cha S (2006) Dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in pediatric patients. Neuroimaging Clin N Am 16:137–147CrossRefPubMed
9.
Ho CY, Cardinal JS, Kamer AP, Kralik SF (2015) Relative cerebral blood volume from dynamic susceptibility contrast perfusion in the grading of pediatric primary brain tumors. Neuroradiology 57:299–306CrossRefPubMed
10.
Warmuth C, Gunther M, Zimmer C (2003) Quantification of blood flow in brain tumors: comparison of arterial spin labeling and dynamic susceptibility-weighted contrast-enhanced MR imaging. Radiology 228:523–532CrossRefPubMed
11.
Wolf RL, Wang J, Wang S, Melhem ER, O'Rourke DM, Judy KD, Detre JA (2005) Grading of CNS neoplasms using continuous arterial spin labeled perfusion MR imaging at 3 tesla. J Magn Reson Imaging 22:475–482CrossRefPubMed
12.
Ata ES, Turgut M, Eraslan C, Dayanır YÖ (2016) Comparison between dynamic susceptibility contrast magnetic resonance imaging and arterial spin labeling techniques in distinguishing malignant from benign brain tumors. Eur J Radiol 85:1545–1553CrossRefPubMed
13.
Haller S, Zaharchuk G, Thomas DL, Lovblad KO, Barkhof F, Golay X (2016) Arterial spin labeling perfusion of the brain: emerging clinical applications. Radiology 281:337–356CrossRefPubMed
14.
Ningning D, Haopeng P, Xuefei D, Wenna C, Yan R, Jingsong W, Chengjun Y, Zhenwei Y, Xiaoyuan F (2017) Perfusion imaging of brain gliomas using arterial spin labeling: correlation with histopathological vascular density in MRI-guided biopsies. Neuroradiology 59:51–59CrossRefPubMed
15.
Grade M, Hernandez Tamames JA, Pizzini FB, Achten E, Golay X, Smits M (2015) A neuroradiologist’s guide to arterial spin labeling MRI in clinical practice. Neuroradiology 57:1181–1202CrossRefPubMedPubMedCentral
16.
Yeom KW, Mitchell LA, Lober RM, Barnes PD, Vogel H, Fisher PG, Edwards MS (2014) Arterial spin-labeled perfusion of pediatric brain tumors. AJNR Am J Neuroradiol 35:395–401CrossRefPubMed
17.
Nabavizadeh SA, Assadsangabi R, Hajmomenian M, Santi M, Vossough A (2015) High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma. Neuroradiology 57:527–533CrossRefPubMed
18.
Dangouloff-Ros V, Deroulers C, Foissac F, Badoual M, Shotar E, Grévent D, Calmon R, Pagès M, Grill J, Dufour C, Blauwblomme T, Puget S, Zerah M, Sainte-Rose C, Brunelle F, Varlet P, Boddaert N (2016) Arterial spin labeling to predict brain tumor grading in children: correlations between histopathologic vascular density and perfusion MR imaging. Radiology 281:553–566CrossRefPubMed
19.
Kikuchi K, Hiwatashi A, Togao O, Yamashita K, Yoshimoto K, Mizoguchi M, Suzuki SO, Iwaki T, Suzuki Y, Honda H (2017) Correlation between arterial spin-labeling perfusion and histopathological vascular density of pediatric intracranial tumors. J Neuro-Oncol 135:561–569CrossRef
20.
Morana G, Piccardo A, Tortora D, Puntoni M, Severino M, Nozza P, Ravegnani M, Consales A, Mascelli S, Raso A, Cabria M, Verrico A, Milanaccio C, Rossi A (2017) Grading and outcome prediction of pediatric diffuse astrocytic tumors with diffusion and arterial spin labeling perfusion MRI in comparison with 18F-DOPA PET. Eur J Nucl Med Mol Imaging 44:2084–2093CrossRefPubMed
21.
Kickingereder P, Sahm F, Radbruch A, Wick W, Heiland S, Deimling A et al (2015) IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with rCBV imaging in human glioma. Sci Rep 5:16238CrossRefPubMedPubMedCentral
22.
Järnum H, Steffensen EG, Knutsson L, Fründ ET, Simonsen CW, Lundbye-Christensen S et al (2010) Perfusion MRI of brain tumours: a comparative study of pseudo-continuous arterial spin labelling and dynamic susceptibility contrast imaging. Neuroradiology 52:307–317CrossRefPubMed
23.
White CM, Pope WB, Zaw T, Qiao J, Naeini KM, Lai A, Nghiemphu PL, Wang JJ, Cloughesy TF, Ellingson BM (2014) Regional and voxel-wise comparisons of blood flow measurements between dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) and arterial spin labeling (ASL) in brain tumors. J Neuroimaging 24:23–30CrossRefPubMed
24.
Roy B, Awasthi R, Bindal A, Sahoo P, Kumar R, Behari S, Ojha BK, Husain N, Pandey CM, Rathore RKS, Gupta RK (2013) Comparative evaluation of 3-dimensional pseudocontinuous arterial spin labeling with dynamic contrast-enhanced perfusion magnetic resonance imaging in grading of human glioma. J Comput Assist Tomogr 37:321–326CrossRefPubMed
25.
Rau MK, Braun C, Skardelly M, Schittenhelm J, Paulsen F, Bender B, Ernemann U, Bisdas S (2014) Prognostic value of blood flow estimated by arterial spin labeling and dynamic susceptibility contrast-enhanced MR imaging in high-grade gliomas. J Neuro-Oncol 120:557–566CrossRef
26.
Lüdemann L, Warmuth C, Plotkin M, Förschler A, Gutberlet M, Wust P, Amthauer H (2009) Brain tumor perfusion: comparison of dynamic contrast enhanced magnetic resonance imaging using T1, T2, and T2* contrast, pulsed arterial spin labeling, and H2(15)O positron emission tomography. Eur J Radiol 70:465–474CrossRefPubMed
27.
Theeler BJ, Ellezam B, Sadighi ZS, Mehta V, Tran MD, Adesina AM, Bruner JM, Puduvalli VK (2014) Adult pilocytic astrocytomas: clinical features and molecular analysis. Neuro-Oncology 16:841–847CrossRefPubMedPubMedCentral
28.
Rossi A, Gandolfo C, Morana G, Severino M, Garrè ML, Cama A (2010) New MR sequences (diffusion, perfusion, spectroscopy) in brain tumours. Pediatr Radiol 40:999–1009CrossRefPubMed
29.
Roy B, Gupta RK, Maudsley AA, Awasthi R, Sheriff S, Gu M, Husain N, Mohakud S, Behari S, Pandey CM, Rathore RKS, Spielman DM, Alger JR (2013) Utility of multiparametric 3-T MRI for glioma characterization. Neuroradiology 55:603–613CrossRefPubMedPubMedCentral
30.
Nguyen TB, Cron GO, Perdrizet K, Bezzina K, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Sinclair J, Thornhill RE, Foottit C, Zanette B, Cameron IG (2015) Comparison of the diagnostic accuracy of DSC- and dynamic contrast-enhanced MRI in the preoperative grading of astrocytomas. AJNR Am J Neuroradiol 36:2017–2022CrossRefPubMed
31.
Zeng Q, Jiang B, Shi F, Ling C, Dong F, Zhang J (2017) 3D Pseudocontinuous arterial spin-labeling MR imaging in the preoperative evaluation of gliomas. AJNR Am J Neuroradiol 38:1876–1883CrossRefPubMed
32.
Calmon R, Puget S, Varlet P, Dangouloff-Ros V, Blauwblomme T, Beccaria K, Grevent D, Sainte-Rose C, Castel D, Debily MA, Dufour C, Bolle S, Dhermain F, Saitovitch A, Zilbovicius M, Brunelle F, Grill J, Boddaert N (2017) Cerebral blood flow changes after radiation therapy identifies pseudo-progression in diffuse intrinsic pontine gliomas. Neuro-Oncology. https://​doi.​org/​10.​1093/​neuonc/​nox227
33.
Gaudino S, Russo R, Verdolotti T, Caulo M, Colosimo C (2016) Advanced MR imaging in hemispheric low-grade gliomas before surgery; the indications and limits in the pediatric age. Childs Nerv Syst 32:1813–1822CrossRefPubMed
34.
Dallery F, Bouzerar R, Michel D, Attencourt C, Promelle V, Peltier J, Constans JM, Balédent O, Gondry-Jouet C (2017) Perfusion magnetic resonance imaging in pediatric brain tumors. Neuroradiology 59:1143–1153CrossRefPubMed
35.
Gupta PK, Saini J, Sahoo P, Patir R, Ahlawat S, Beniwal M, Thennarasu K, Santosh V, Gupta RK (2017) Role of dynamic contrast-enhanced perfusion magnetic resonance imaging in grading of pediatric brain tumors on 3T. Pediatr Neurosurg 52:298–305CrossRefPubMed
36.
Grand SD, Kremer S, Tropres IM, Hoffmann DM, Chabardes SJ, Lefournier V, Berger FR, Pasteris C, Krainik A, Pasquier BM, Peoch M, le Bas JF (2007) Perfusion-sensitive MRI of pilocytic astrocytomas: initial results. Neuroradiology 49:545–550CrossRefPubMed
37.
Banan R, Hartmann C (2017) The new WHO 2016 classification of brain tumors-what neurosurgeons need to know. Acta Neurochir 159:403–418CrossRefPubMed
38.
Aboian MS, Solomon DA, Felton E, Mabray MC, Villanueva-Meyer JE, Mueller S, Cha S (2017) Imaging characteristics of pediatric diffuse midline gliomas with histone H3 K27M mutation. AJNR Am J Neuroradiol 38:795–800CrossRefPubMedPubMedCentral
39.
Alsop DC, Detre JA, Golay X, Günther M, Hendrikse J, Hernandez-Garcia L, Lu H, MacIntosh BJ, Parkes LM, Smits M, van Osch MJP, Wang DJJ, Wong EC, Zaharchuk G (2015) Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia. Magn Reson Med 73:102–116CrossRefPubMed
Metadata
Title
Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI perfusion
Authors
Giovanni Morana
Domenico Tortora
Serena Staglianò
Paolo Nozza
Samantha Mascelli
Mariasavina Severino
Gianluca Piatelli
Alessandro Consales
Maarten Lequin
Maria Luisa Garrè
Andrea Rossi
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 4/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-018-1992-6

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