Comparison between Dynamic Contrast-Enhanced MRI and Dynamic Susceptibility Contrast MRI in Glioma Grading

Abstract

Objective: To determine the usefulness of the dynamic contrast enhanced MRI (DCE-MRI) technique for differentiating between low grade glioma and high grade glioma and compare with dynamic susceptibility contrast (DSC) MRI.
Methods: Conventional MRI, DCE-MRI and DSC-MRI were performed preoperatively in 17 patients with gliomas. Permeability indices (K^trans, rK^trans, V_e and K_ep) from DCE-MRI and cerebral blood volume (CBV), rCBV from DSC-MRI were quantified. The differences in K^trans, rK^trans, V_e, K_ep, CBV and rCBV between low grade glioma and high grade glioma were analyzed and compared. Receiver operating characteristic (ROC) curve analyses were conducted.
Results: K^trans, rK^trans, V_e, CBV and rCBV were significantly different between low grade glioma and high grade glioma (p = 0.001, 0.014, 0.02, 0.025, and 0.034, respectively). The areas under the ROC curve for K^trans, rK^trans, V_e, rCBV and CBV were 0.986, 0.896, 0.829, 0.852, and 0.833, respectively. K^trans was the best parameter for differentiating low grade glioma from high grade glioma with cutoff value of 0.0091 min^-1 (sensitivity 100%, specificity 80%, PPV 87.5%, NPV 100%, accuracy 94.1%).
Conclusion: DCE-MRI could be used to estimate neovascular permeability and for pre-operative grading of glioma. Among the perfusion parameters, K^trans was the best parameter for differentiating low grade glioma from high grade glioma . DCE-MRI may be promising for better diagnostic performance than DSC-MRI.