Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images

Nicoletta Anzalone, Antonella Castellano, Marcello Cadioli, Gian Marco Conte, Valeria Cuccarini, Alberto Bizzi, Marco Grimaldi, Antonella Costa, Giovanni Grillea, Paolo Vitali, Domenico Aquino, Maria Rosa Terreni, Valter Torri, Bradley J Erickson, Massimo Caulo

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose To evaluate the feasibility of a standardized protocol for acquisition and analysis of dynamic contrast material-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging in a multicenter clinical setting and to verify its accuracy in predicting glioma grade according to the new World Health Organization 2016 classification. Materials and Methods The local research ethics committees of all centers approved the study, and informed consent was obtained from patients. One hundred patients with glioma were prospectively examined at 3.0 T in seven centers that performed the same preoperative MR imaging protocol, including DCE and DSC sequences. Two independent readers identified the perfusion hotspots on maps of volume transfer constant (Ktrans), plasma (vp) and extravascular-extracellular space (ve) volumes, initial area under the concentration curve, and relative cerebral blood volume (rCBV). Differences in parameters between grades and molecular subtypes were assessed by using Kruskal-Wallis and Mann-Whitney U tests. Diagnostic accuracy was evaluated by using receiver operating characteristic curve analysis. Results The whole protocol was tolerated in all patients. Perfusion maps were successfully obtained in 94 patients. An excellent interreader reproducibility of DSC- and DCE-derived measures was found. Among DCE-derived parameters, vp and ve had the highest accuracy (are under the receiver operating characteristic curve [Az] = 0.847 and 0.853) for glioma grading. DSC-derived rCBV had the highest accuracy (Az = 0.894), but the difference was not statistically significant (P > .05). Among lower-grade gliomas, a moderate increase in both vp and rCBV was evident in isocitrate dehydrogenase wild-type tumors, although this was not significant (P > .05). Conclusion A standardized multicenter acquisition and analysis protocol of DCE and DSC MR imaging is feasible and highly reproducible. Both techniques showed a comparable, high diagnostic accuracy for grading gliomas.

Original languageEnglish (US)
Pages (from-to)933-943
Number of pages11
JournalRadiology
Volume287
Issue number3
DOIs
StatePublished - Jun 1 2018
Externally publishedYes

Fingerprint

Glioma
Contrast Media
Magnetic Resonance Spectroscopy
Brain
Magnetic Resonance Imaging
ROC Curve
Perfusion
Isocitrate Dehydrogenase
Research Ethics Committees
Extracellular Space
Nonparametric Statistics
Informed Consent
Area Under Curve
Cerebral Blood Volume
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Anzalone, N., Castellano, A., Cadioli, M., Conte, G. M., Cuccarini, V., Bizzi, A., ... Caulo, M. (2018). Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images. Radiology, 287(3), 933-943. https://doi.org/10.1148/radiol.2017170362

Brain Gliomas : Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images. / Anzalone, Nicoletta; Castellano, Antonella; Cadioli, Marcello; Conte, Gian Marco; Cuccarini, Valeria; Bizzi, Alberto; Grimaldi, Marco; Costa, Antonella; Grillea, Giovanni; Vitali, Paolo; Aquino, Domenico; Terreni, Maria Rosa; Torri, Valter; Erickson, Bradley J; Caulo, Massimo.

In: Radiology, Vol. 287, No. 3, 01.06.2018, p. 933-943.

Research output: Contribution to journalArticle

Anzalone, N, Castellano, A, Cadioli, M, Conte, GM, Cuccarini, V, Bizzi, A, Grimaldi, M, Costa, A, Grillea, G, Vitali, P, Aquino, D, Terreni, MR, Torri, V, Erickson, BJ & Caulo, M 2018, 'Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images', Radiology, vol. 287, no. 3, pp. 933-943. https://doi.org/10.1148/radiol.2017170362
Anzalone, Nicoletta ; Castellano, Antonella ; Cadioli, Marcello ; Conte, Gian Marco ; Cuccarini, Valeria ; Bizzi, Alberto ; Grimaldi, Marco ; Costa, Antonella ; Grillea, Giovanni ; Vitali, Paolo ; Aquino, Domenico ; Terreni, Maria Rosa ; Torri, Valter ; Erickson, Bradley J ; Caulo, Massimo. / Brain Gliomas : Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images. In: Radiology. 2018 ; Vol. 287, No. 3. pp. 933-943.
@article{7e661af6b25a4aa89a116dd4e3eae0d0,
title = "Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images",
abstract = "Purpose To evaluate the feasibility of a standardized protocol for acquisition and analysis of dynamic contrast material-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging in a multicenter clinical setting and to verify its accuracy in predicting glioma grade according to the new World Health Organization 2016 classification. Materials and Methods The local research ethics committees of all centers approved the study, and informed consent was obtained from patients. One hundred patients with glioma were prospectively examined at 3.0 T in seven centers that performed the same preoperative MR imaging protocol, including DCE and DSC sequences. Two independent readers identified the perfusion hotspots on maps of volume transfer constant (Ktrans), plasma (vp) and extravascular-extracellular space (ve) volumes, initial area under the concentration curve, and relative cerebral blood volume (rCBV). Differences in parameters between grades and molecular subtypes were assessed by using Kruskal-Wallis and Mann-Whitney U tests. Diagnostic accuracy was evaluated by using receiver operating characteristic curve analysis. Results The whole protocol was tolerated in all patients. Perfusion maps were successfully obtained in 94 patients. An excellent interreader reproducibility of DSC- and DCE-derived measures was found. Among DCE-derived parameters, vp and ve had the highest accuracy (are under the receiver operating characteristic curve [Az] = 0.847 and 0.853) for glioma grading. DSC-derived rCBV had the highest accuracy (Az = 0.894), but the difference was not statistically significant (P > .05). Among lower-grade gliomas, a moderate increase in both vp and rCBV was evident in isocitrate dehydrogenase wild-type tumors, although this was not significant (P > .05). Conclusion A standardized multicenter acquisition and analysis protocol of DCE and DSC MR imaging is feasible and highly reproducible. Both techniques showed a comparable, high diagnostic accuracy for grading gliomas.",
author = "Nicoletta Anzalone and Antonella Castellano and Marcello Cadioli and Conte, {Gian Marco} and Valeria Cuccarini and Alberto Bizzi and Marco Grimaldi and Antonella Costa and Giovanni Grillea and Paolo Vitali and Domenico Aquino and Terreni, {Maria Rosa} and Valter Torri and Erickson, {Bradley J} and Massimo Caulo",
year = "2018",
month = "6",
day = "1",
doi = "10.1148/radiol.2017170362",
language = "English (US)",
volume = "287",
pages = "933--943",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Brain Gliomas

T2 - Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images

AU - Anzalone, Nicoletta

AU - Castellano, Antonella

AU - Cadioli, Marcello

AU - Conte, Gian Marco

AU - Cuccarini, Valeria

AU - Bizzi, Alberto

AU - Grimaldi, Marco

AU - Costa, Antonella

AU - Grillea, Giovanni

AU - Vitali, Paolo

AU - Aquino, Domenico

AU - Terreni, Maria Rosa

AU - Torri, Valter

AU - Erickson, Bradley J

AU - Caulo, Massimo

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Purpose To evaluate the feasibility of a standardized protocol for acquisition and analysis of dynamic contrast material-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging in a multicenter clinical setting and to verify its accuracy in predicting glioma grade according to the new World Health Organization 2016 classification. Materials and Methods The local research ethics committees of all centers approved the study, and informed consent was obtained from patients. One hundred patients with glioma were prospectively examined at 3.0 T in seven centers that performed the same preoperative MR imaging protocol, including DCE and DSC sequences. Two independent readers identified the perfusion hotspots on maps of volume transfer constant (Ktrans), plasma (vp) and extravascular-extracellular space (ve) volumes, initial area under the concentration curve, and relative cerebral blood volume (rCBV). Differences in parameters between grades and molecular subtypes were assessed by using Kruskal-Wallis and Mann-Whitney U tests. Diagnostic accuracy was evaluated by using receiver operating characteristic curve analysis. Results The whole protocol was tolerated in all patients. Perfusion maps were successfully obtained in 94 patients. An excellent interreader reproducibility of DSC- and DCE-derived measures was found. Among DCE-derived parameters, vp and ve had the highest accuracy (are under the receiver operating characteristic curve [Az] = 0.847 and 0.853) for glioma grading. DSC-derived rCBV had the highest accuracy (Az = 0.894), but the difference was not statistically significant (P > .05). Among lower-grade gliomas, a moderate increase in both vp and rCBV was evident in isocitrate dehydrogenase wild-type tumors, although this was not significant (P > .05). Conclusion A standardized multicenter acquisition and analysis protocol of DCE and DSC MR imaging is feasible and highly reproducible. Both techniques showed a comparable, high diagnostic accuracy for grading gliomas.

AB - Purpose To evaluate the feasibility of a standardized protocol for acquisition and analysis of dynamic contrast material-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging in a multicenter clinical setting and to verify its accuracy in predicting glioma grade according to the new World Health Organization 2016 classification. Materials and Methods The local research ethics committees of all centers approved the study, and informed consent was obtained from patients. One hundred patients with glioma were prospectively examined at 3.0 T in seven centers that performed the same preoperative MR imaging protocol, including DCE and DSC sequences. Two independent readers identified the perfusion hotspots on maps of volume transfer constant (Ktrans), plasma (vp) and extravascular-extracellular space (ve) volumes, initial area under the concentration curve, and relative cerebral blood volume (rCBV). Differences in parameters between grades and molecular subtypes were assessed by using Kruskal-Wallis and Mann-Whitney U tests. Diagnostic accuracy was evaluated by using receiver operating characteristic curve analysis. Results The whole protocol was tolerated in all patients. Perfusion maps were successfully obtained in 94 patients. An excellent interreader reproducibility of DSC- and DCE-derived measures was found. Among DCE-derived parameters, vp and ve had the highest accuracy (are under the receiver operating characteristic curve [Az] = 0.847 and 0.853) for glioma grading. DSC-derived rCBV had the highest accuracy (Az = 0.894), but the difference was not statistically significant (P > .05). Among lower-grade gliomas, a moderate increase in both vp and rCBV was evident in isocitrate dehydrogenase wild-type tumors, although this was not significant (P > .05). Conclusion A standardized multicenter acquisition and analysis protocol of DCE and DSC MR imaging is feasible and highly reproducible. Both techniques showed a comparable, high diagnostic accuracy for grading gliomas.

UR - http://www.scopus.com/inward/record.url?scp=85049557447&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049557447&partnerID=8YFLogxK

U2 - 10.1148/radiol.2017170362

DO - 10.1148/radiol.2017170362

M3 - Article

C2 - 29361245

AN - SCOPUS:85049557447

VL - 287

SP - 933

EP - 943

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -