Eur Rev Med Pharmacol Sci 2022; 26 (21): 7938-7948

DOI: 10.26355/eurrev_202211_30145

Diagnostic performance of MRI perfusion and spectroscopy for brainstem glioma grading

D. Tran, D.H. Nguyen, H.K. Nguyen, V.-A. Nguyen-Thanh, H. Dong-Van, M.D. Nguyen

Neurosurgery Center, Viet Duc Hospital, Hanoi, Vietnam. bsnguyenminhduc@pnt.edu.vn


OBJECTIVE: This study investigated the roles of dynamic susceptibility contrast (DSC) perfusion and multivoxel magnetic resonance spectroscopy (MRS) in grading brainstem glioma (BSG).

PATIENTS AND METHODS: Our retrospective study comprised 12 patients, including 6 with pathology verified low-grade BSGs and 6 with high-grade BSGs. We examined differences in age, relative cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), and the metabolite ratios of choline (Cho)/N-acetyl aspartate (NAA) and Cho/creatine (Cr) between these two groups using the Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve analysis was used to establish cutoff values and assess their usefulness in grading BSG.

RESULTS: The Cho/NAA metabolite ratio had the strongest preoperative predictive performance for identifying the correct histological grade among BSGs, with an area under the ROC curve (AUC) value of 0.944 (cutoff: 3.88, sensitivity [Se]: 83.3%; specificity [Sp]: 100%), followed by the Cho/Cr ratio (cutoff: 3.08; AUC: 0.917; Se: 83.3%; Sp: 100%), rCBF (cutoff: 3.56, AUC: 0.917; Se: 83.3%; Sp: 100%), rCBV (cutoff: 3.16, AUC: 0.889; Se: 100%; Sp: 66.7%), and age (cutoff: 9.5 years, AUC: 0.889; Se: 100%; Sp: 83.3%).

CONCLUSIONS: rCBF and rCBV values comparing solid tumors with the normal brain parenchyma and the metabolite ratios for Cho/NAA and Cho/Cre may serve as useful indices for establishing BSG grading and provide important information when determining treatment planning and prognosis in patients with BSG.

Free PDF Download

To cite this article

D. Tran, D.H. Nguyen, H.K. Nguyen, V.-A. Nguyen-Thanh, H. Dong-Van, M.D. Nguyen
Diagnostic performance of MRI perfusion and spectroscopy for brainstem glioma grading

Eur Rev Med Pharmacol Sci
Year: 2022
Vol. 26 - N. 21
Pages: 7938-7948
DOI: 10.26355/eurrev_202211_30145