Gliomas: Application of Cumulative Histogram Analysis of Normalized Cerebral Blood Volume on 3 T MRI to Tumor Grading

Hyungjin Kim, Seung Hong Choi, Ji Hoon Kim, Inseon Ryoo, Soo Chin Kim, Jeong A. Yeom, Hwaseon Shin, Seung Chai Jung, A. Leum Lee, Tae Jin Yun, Chul Kee Park, Chul Ho Sohn, Sung Hye Park

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background:Glioma grading assumes significant importance in that low- and high-grade gliomas display different prognoses and are treated with dissimilar therapeutic strategies. The objective of our study was to retrospectively assess the usefulness of a cumulative normalized cerebral blood volume (nCBV) histogram for glioma grading based on 3 T MRI.Methods:From February 2010 to April 2012, 63 patients with astrocytic tumors underwent 3 T MRI with dynamic susceptibility contrast perfusion-weighted imaging. Regions of interest containing the entire tumor volume were drawn on every section of the co-registered relative CBV (rCBV) maps and T2-weighted images. The percentile values from the cumulative nCBV histograms and the other histogram parameters were correlated with tumor grades. Cochran's Q test and the McNemar test were used to compare the diagnostic accuracies of the histogram parameters after the receiver operating characteristic curve analysis. Using the parameter offering the highest diagnostic accuracy, a validation process was performed with an independent test set of nine patients.Results:The 99th percentile of the cumulative nCBV histogram (nCBV C99), mean and peak height differed significantly between low- and high-grade gliomas (P = <0.001, 0.014 and <0.001, respectively) and between grade III and IV gliomas (P = <0.001, 0.001 and <0.001, respectively). The diagnostic accuracy of nCBV C99 was significantly higher than that of the mean nCBV (P = 0.016) in distinguishing high- from low-grade gliomas and was comparable to that of the peak height (P = 1.000). Validation using the two cutoff values of nCBV C99 achieved a diagnostic accuracy of 66.7% (6/9) for the separation of all three glioma grades.Conclusion:Cumulative histogram analysis of nCBV using 3 T MRI can be a useful method for preoperative glioma grading. The nCBV C99 value is helpful in distinguishing high- from low-grade gliomas and grade IV from III gliomas.

Original languageEnglish
Article numbere63462
JournalPLoS One
Volume8
Issue number5
DOIs
Publication statusPublished - 2013 May 21
Externally publishedYes

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blood volume
Neoplasm Grading
Glioma
Magnetic resonance imaging
Tumors
Blood
neoplasms
Cerebral Blood Volume
testing
Perfusion Imaging
prognosis
Tumor Burden
ROC Curve
Neoplasms
image analysis
Imaging techniques
therapeutics

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Gliomas : Application of Cumulative Histogram Analysis of Normalized Cerebral Blood Volume on 3 T MRI to Tumor Grading. / Kim, Hyungjin; Choi, Seung Hong; Kim, Ji Hoon; Ryoo, Inseon; Kim, Soo Chin; Yeom, Jeong A.; Shin, Hwaseon; Jung, Seung Chai; Lee, A. Leum; Yun, Tae Jin; Park, Chul Kee; Sohn, Chul Ho; Park, Sung Hye.

In: PLoS One, Vol. 8, No. 5, e63462, 21.05.2013.

Research output: Contribution to journalArticle

Kim, H, Choi, SH, Kim, JH, Ryoo, I, Kim, SC, Yeom, JA, Shin, H, Jung, SC, Lee, AL, Yun, TJ, Park, CK, Sohn, CH & Park, SH 2013, 'Gliomas: Application of Cumulative Histogram Analysis of Normalized Cerebral Blood Volume on 3 T MRI to Tumor Grading', PLoS One, vol. 8, no. 5, e63462. https://doi.org/10.1371/journal.pone.0063462
Kim, Hyungjin ; Choi, Seung Hong ; Kim, Ji Hoon ; Ryoo, Inseon ; Kim, Soo Chin ; Yeom, Jeong A. ; Shin, Hwaseon ; Jung, Seung Chai ; Lee, A. Leum ; Yun, Tae Jin ; Park, Chul Kee ; Sohn, Chul Ho ; Park, Sung Hye. / Gliomas : Application of Cumulative Histogram Analysis of Normalized Cerebral Blood Volume on 3 T MRI to Tumor Grading. In: PLoS One. 2013 ; Vol. 8, No. 5.
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abstract = "Background:Glioma grading assumes significant importance in that low- and high-grade gliomas display different prognoses and are treated with dissimilar therapeutic strategies. The objective of our study was to retrospectively assess the usefulness of a cumulative normalized cerebral blood volume (nCBV) histogram for glioma grading based on 3 T MRI.Methods:From February 2010 to April 2012, 63 patients with astrocytic tumors underwent 3 T MRI with dynamic susceptibility contrast perfusion-weighted imaging. Regions of interest containing the entire tumor volume were drawn on every section of the co-registered relative CBV (rCBV) maps and T2-weighted images. The percentile values from the cumulative nCBV histograms and the other histogram parameters were correlated with tumor grades. Cochran's Q test and the McNemar test were used to compare the diagnostic accuracies of the histogram parameters after the receiver operating characteristic curve analysis. Using the parameter offering the highest diagnostic accuracy, a validation process was performed with an independent test set of nine patients.Results:The 99th percentile of the cumulative nCBV histogram (nCBV C99), mean and peak height differed significantly between low- and high-grade gliomas (P = <0.001, 0.014 and <0.001, respectively) and between grade III and IV gliomas (P = <0.001, 0.001 and <0.001, respectively). The diagnostic accuracy of nCBV C99 was significantly higher than that of the mean nCBV (P = 0.016) in distinguishing high- from low-grade gliomas and was comparable to that of the peak height (P = 1.000). Validation using the two cutoff values of nCBV C99 achieved a diagnostic accuracy of 66.7{\%} (6/9) for the separation of all three glioma grades.Conclusion:Cumulative histogram analysis of nCBV using 3 T MRI can be a useful method for preoperative glioma grading. The nCBV C99 value is helpful in distinguishing high- from low-grade gliomas and grade IV from III gliomas.",
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AU - Ryoo, Inseon

AU - Kim, Soo Chin

AU - Yeom, Jeong A.

AU - Shin, Hwaseon

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