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La radiologia medica
Published in: La radiologia medica 8/2014

01-08-2014 | Magnetic Resonance Imaging

Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach

Authors: Alfonso Di Costanzo, Tommaso Scarabino, Francesca Trojsi, Teresa Popolizio, Simona Bonavita, Mario de Cristofaro, Renata Conforti, Adriana Cristofano, Claudio Colonnese, Ugo Salvolini, Gioacchino Tedeschi

Published in: La radiologia medica | Issue 8/2014

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Abstract

Objective

The discrimination between recurrent glioma and radiation injury is often a challenge on conventional magnetic resonance imaging (MRI). We verified whether adding and combining proton MR spectroscopic imaging (1H-MRSI), diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) information at 3 Tesla facilitate such discrimination.

Materials and methods

Twenty-nine patients with histologically verified high-grade gliomas, who had undergone surgical resection and radiotherapy, and had developed new contrast-enhancing lesions close to the treated tumour, underwent MRI, 1H-MRSI, DWI and PWI at regular time intervals. The metabolite ratios choline (Cho)/normal( n )Cho n , N-acetylaspartate (NAA)/NAA n , creatine (Cr)/Cr n , lactate/lipids (LL)/LL n , Cho/Cr n , NAA/Cr n , Cho/NAA, NAA/Cr and Cho/Cr were derived from 1H-MRSI; the apparent diffusion coefficient (ADC) from DWI; and the relative cerebral blood volume (rCBV) from PWI.

Results

In serial MRI, recurrent gliomas showed a progressive enlargement, and radiation injuries showed regression or no modification. Discriminant analysis showed that discrimination accuracy was 79.3 % when considering only the metabolite ratios (predictor, Cho/Cr n ), 86.2 % when considering ratios and ADC (predictors, Cho/Cr n and ADC), 89.7 % when considering ratios and rCBV (predictors, Cho/Cr n , Cho/Cr and rCBV), and 96.6 % when considering ratios, ADC and rCBV (predictors, Cho/Cho n , ADC and rCBV).

Conclusions

The multiparametric 3-T MR assessment based on 1H-MRSI, DWI and PWI in addition to MRI is a useful tool to discriminate tumour recurrence/progression from radiation effects.
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Metadata
Title
Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach
Authors
Alfonso Di Costanzo
Tommaso Scarabino
Francesca Trojsi
Teresa Popolizio
Simona Bonavita
Mario de Cristofaro
Renata Conforti
Adriana Cristofano
Claudio Colonnese
Ugo Salvolini
Gioacchino Tedeschi
Publication date
01-08-2014
Publisher
Springer Milan
Published in
La radiologia medica / Issue 8/2014
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-013-0371-y

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