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Simplified perfusion fraction from diffusion-weighted imaging in preoperative prediction of IDH1 mutation in WHO grade II–III gliomas: comparison with dynamic contrast-enhanced and intravoxel incoherent motion MRI

Xiaoqing Wang
Xiaoqing Wang
, 
Mengqiu Cao
Mengqiu Cao
, 
Hongjin Chen
Hongjin Chen
, 
Jianwei Ge
Jianwei Ge
, 
Shiteng Suo
Shiteng Suo
 and 
Yan Zhou
Yan Zhou
   | Jun 19, 2020
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Article Category: Research Article
Published Online: Jun 19, 2020
Page range: 301 - 310
Received: Mar 23, 2020
Accepted: May 13, 2020
DOI: https://doi.org/10.2478/raon-2020-0037
© 2020 Xiaoqing Wang, Mengqiu Cao, Hongjin Chen, Jianwei Ge, Shiteng Suo, Yan Zhou, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background

Effect of isocitr ate dehydrogenase 1 (IDH1) mutation in neovascularization might be linked with tissue perfusion in gliomas. At present, the need of injection of contrast agent and the increasing scanning time limit the application of perfusion techniques. We used a simplified intravoxel incoherent motion (IVIM)-derived perfusion fraction (SPF) calculated from diffusion-weighted imaging (DWI) using only three b-values to quantitatively assess IDH1-linked tissue perfusion changes in WHO grade II-III gliomas (LGGs). Additionally, by comparing accuracy with dynamic contrast-enhanced (DCE) and full IVIM MRI, we tried to find the optimal imaging markers to predict IDH1 mutation status.

Patients and methods

Thirty patients were prospectively examined using DCE and multi-b-value DWI. All parameters were compared between the IDH1 mutant and wild-type LGGs using the Mann–Whitney U test, including the DCE MRI-derived Ktrans, ve and vp, the conventional apparen t diffusion coefficient (ADC0,1000), IVIM-de rived perfusion fraction (f), diffusion coefficient (D) and pseudo-diffusion coefficient (D*), SPF. We evaluated the diagnostic performance by receive r operating characteristic (ROC) analysis.

Results

Significant differences were detected between WHO grade II-III gliomas for all perfusion and diffusion parameters (P < 0.05). When compared to IDH1 mutant LGGs, IDH1 wild-type LGGs exhibited significantly higher perfusion metrics (P < 0.05) and lower diffusion metrics (P < 0.05). Among all parameters, SPF showed a higher diagnostic performance (area under the curve 0.861), with 94.4% sensitivity and 75% specificity.

Conclusions

DWI, DCE and IVIM MRI may noninvasively help discriminate IDH1 mutation statuses in LGGs. Specifically, simplified DWI-derived SPF showed a superior diagnostic performance.

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Language:
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Medicine, Clinical Medicine, Radiology, Internal Medicine, Haematology, Oncology
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