DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI

Objective: to elaborate differential diagnostic criteria for recurrent gliomas after combination treatment, by using dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) and T2*-weighted perfusion magnetic resonance imaging (MRI).Material and methods. The retrospective study enrolled 1...

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Main Authors: O. Yu. Borodin, V. Yu. Usov
Format: Article
Language:English
Published: Luchevaya Diagnostika, LLC 2018-03-01
Series:Вестник рентгенологии и радиологии
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Online Access:https://www.russianradiology.ru/jour/article/view/218
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author O. Yu. Borodin
V. Yu. Usov
author_facet O. Yu. Borodin
V. Yu. Usov
author_sort O. Yu. Borodin
collection DOAJ
description Objective: to elaborate differential diagnostic criteria for recurrent gliomas after combination treatment, by using dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) and T2*-weighted perfusion magnetic resonance imaging (MRI).Material and methods. The retrospective study enrolled 16 men and 7 women (mean age 34.6±15.4 years) who had undergone multiparametric magnetic resonance imaging of the brain to prevent cancer recurrence after combination treatment. The study used the following protocols: 1) static contrast-enhanced MRI, including T2- and T1-weighted MRI, and post-contrastenhanced T1-weighted images at 5–8 minutes after DCE-MPA); 2) DCE-MPA at a dose of 0.2 mmol/kg; 3) in the presence of precontrast-enhanced T2*-weighted perfusion MRI at a dose of 0.1 mmol/kg. A morphological diagnosis was done in all cases. Tumor hemodynamics was evaluated by DCE-MRA using contrast ratios (CR or CBR) in each scanning phase, as well as contrastenhancement ratios (ER or CER) and a venous-arterial ratio in the first venous phase (VAR1). Relative Cerebral Blood Volumes (rCBV) were estimated on the contrast-enhanced T1-weighted perfusion maps. Statistical processing of the results was performed using ROC analysis.Results. According to T2*-weighted perfusion MRI and the results of a follow-up using the RECIST criteria, the investigators formed two comparison groups: 1) progressions (n = 7 (30.4%)) with increased rCBV (>1.75) and 2) stabilization (n = 16 (69.6%)) with reduced rCBV (<1.75). Based on the found threshold values of hemodynamic parameters at DCE-MPA (VAR1 = 1.59) and T2*-weighted perfusion MRI (rCBV = 1.75), they were compared with operational characteristics, which could classify 5 types of hemodynamics (G0–G4) in relation to rCBV and VAR1. A relapse was detected when the category of tumor malignancy coincided with the type of hemodynamics (VAR1 > 1.59), stabilization was found with a decrease (VAR1<1.59), as demonstrated by DCEMRA with 64% sensitivity and 94% specificity.Conclusion. The developed classification of types of hemodynamics at DCE-MRA allows the differential diagnosis of recurrence from stabilization.
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spelling doaj-art-555c19d887dd4b25902f3dc316c81bd72025-08-20T03:58:45ZengLuchevaya Diagnostika, LLCВестник рентгенологии и радиологии0042-46762619-04782018-03-0199151210.20862/0042-4676-2018-99-1-5-12213DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRIO. Yu. Borodin0V. Yu. Usov1Tomsk Regional Oncology Center; Cardiology Research Institute, Tomsk National Research Medical Center of Russian Academy of Sciences; Siberian State Medical University, Ministry of Health of the Russian FederationCardiology Research Institute, Tomsk National Research Medical Center of Russian Academy of SciencesObjective: to elaborate differential diagnostic criteria for recurrent gliomas after combination treatment, by using dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) and T2*-weighted perfusion magnetic resonance imaging (MRI).Material and methods. The retrospective study enrolled 16 men and 7 women (mean age 34.6±15.4 years) who had undergone multiparametric magnetic resonance imaging of the brain to prevent cancer recurrence after combination treatment. The study used the following protocols: 1) static contrast-enhanced MRI, including T2- and T1-weighted MRI, and post-contrastenhanced T1-weighted images at 5–8 minutes after DCE-MPA); 2) DCE-MPA at a dose of 0.2 mmol/kg; 3) in the presence of precontrast-enhanced T2*-weighted perfusion MRI at a dose of 0.1 mmol/kg. A morphological diagnosis was done in all cases. Tumor hemodynamics was evaluated by DCE-MRA using contrast ratios (CR or CBR) in each scanning phase, as well as contrastenhancement ratios (ER or CER) and a venous-arterial ratio in the first venous phase (VAR1). Relative Cerebral Blood Volumes (rCBV) were estimated on the contrast-enhanced T1-weighted perfusion maps. Statistical processing of the results was performed using ROC analysis.Results. According to T2*-weighted perfusion MRI and the results of a follow-up using the RECIST criteria, the investigators formed two comparison groups: 1) progressions (n = 7 (30.4%)) with increased rCBV (>1.75) and 2) stabilization (n = 16 (69.6%)) with reduced rCBV (<1.75). Based on the found threshold values of hemodynamic parameters at DCE-MPA (VAR1 = 1.59) and T2*-weighted perfusion MRI (rCBV = 1.75), they were compared with operational characteristics, which could classify 5 types of hemodynamics (G0–G4) in relation to rCBV and VAR1. A relapse was detected when the category of tumor malignancy coincided with the type of hemodynamics (VAR1 > 1.59), stabilization was found with a decrease (VAR1<1.59), as demonstrated by DCEMRA with 64% sensitivity and 94% specificity.Conclusion. The developed classification of types of hemodynamics at DCE-MRA allows the differential diagnosis of recurrence from stabilization.https://www.russianradiology.ru/jour/article/view/218dynamic contrast-enhanced magnetic resonance angiographyperfusionbraintumorprogressionrecurrencestabilization
spellingShingle O. Yu. Borodin
V. Yu. Usov
DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
Вестник рентгенологии и радиологии
dynamic contrast-enhanced magnetic resonance angiography
perfusion
brain
tumor
progression
recurrence
stabilization
title DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
title_full DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
title_fullStr DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
title_full_unstemmed DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
title_short DIFFERENTIAL AND DIAGNOSTIC CRITERIA OF THE RECURRENCE OF GLIOMAS IN THE POST-OPERATIONAL PERIOD USING OF DYNAMIC CONTRAST-ENHANCED MRA AND PERFUSION MRI
title_sort differential and diagnostic criteria of the recurrence of gliomas in the post operational period using of dynamic contrast enhanced mra and perfusion mri
topic dynamic contrast-enhanced magnetic resonance angiography
perfusion
brain
tumor
progression
recurrence
stabilization
url https://www.russianradiology.ru/jour/article/view/218
work_keys_str_mv AT oyuborodin differentialanddiagnosticcriteriaoftherecurrenceofgliomasinthepostoperationalperiodusingofdynamiccontrastenhancedmraandperfusionmri
AT vyuusov differentialanddiagnosticcriteriaoftherecurrenceofgliomasinthepostoperationalperiodusingofdynamiccontrastenhancedmraandperfusionmri