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European Radiology
Published in: European Radiology 9/2018

Open Access 01-09-2018 | Neuro

Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis

Authors: S. C. Thust, S. Hassanein, S. Bisdas, J. H. Rees, H. Hyare, J. A. Maynard, S. Brandner, C. Tur, H. R. Jäger, T. A. Yousry, L. Mancini

Published in: European Radiology | Issue 9/2018

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Abstract

Objectives

To investigate if quantitative apparent diffusion coefficient (ADC) measurements can predict genetic subtypes of non-gadolinium-enhancing gliomas, comparing whole tumour against single slice analysis.

Methods

Volumetric T2-derived masks of 44 gliomas were co-registered to ADC maps with ADC mean (ADCmean) calculated. For the slice analysis, two observers placed regions of interest in the largest tumour cross-section. The ratio (ADCratio) between ADCmean in the tumour and normal appearing white matter was calculated for both methods.

Results

Isocitrate dehydrogenase (IDH) wild-type gliomas showed the lowest ADC values throughout (p < 0.001). ADCmean in the IDH-mutant 1p19q intact group was significantly higher than in the IDH-mutant 1p19q co-deleted group (p < 0.01). A volumetric ADCmean threshold of 1201 × 10−6 mm2/s identified IDH wild-type with a sensitivity of 83% and a specificity of 86%; a volumetric ADCratio cut-off value of 1.65 provided a sensitivity of 80% and a specificity of 92% (area under the curve (AUC) 0.9–0.94). A slice ADCratio threshold for observer 1 (observer 2) of 1.76 (1.83) provided a sensitivity of 80% (86%), specificity of 91% (100%) and AUC of 0.95 (0.96). The intraclass correlation coefficient was excellent (0.98).

Conclusions

ADC measurements can support the distinction of glioma subtypes. Volumetric and two-dimensional measurements yielded similar results in this study.

Key Points

• Diffusion-weighted MRI aids the identification of non-gadolinium-enhancing malignant gliomas
• ADC measurements may permit non-gadolinium-enhancing glioma molecular subtyping
• IDH wild-type gliomas have lower ADC values than IDH-mutant tumours
• Single cross-section and volumetric ADC measurements yielded comparable results in this study
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Metadata
Title
Apparent diffusion coefficient for molecular subtyping of non-gadolinium-enhancing WHO grade II/III glioma: volumetric segmentation versus two-dimensional region of interest analysis
Authors
S. C. Thust
S. Hassanein
S. Bisdas
J. H. Rees
H. Hyare
J. A. Maynard
S. Brandner
C. Tur
H. R. Jäger
T. A. Yousry
L. Mancini
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5351-0

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