DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions
Purpose The presurgical discrimination of IDH-mutant astrocytoma grade 4 from IDH-wildtype glioblastoma is crucial for patient management, especially in younger adults, aiding in prognostic assessment, guiding molecular diagnostics and surgical planning, and identifying candidates for IDH-targeted t...
| Authors: | ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2024 |
| Country: | España |
| Institution: | Universidad de Barcelona |
| Repository: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:dnet:ubarcelona__::b70b7abdc793518a209c67785445eadc |
| Online Access: | https://hdl.handle.net/2445/228829 |
| Access Level: | Open access |
| Keyword: | Imatges per ressonància magnètica Tumors cerebrals Magnetic resonance imaging Brain tumors |
| _version_ | 1878729877290483712 |
|---|---|
| author | Pons Escoda, Albert |
| author2 | Naval Baudin, Pablo Viveros, Mildred Flores-Casaperalta, Susanie Martínez Zalacaín, Ignacio Plans, Gerard Vidal Sarró, Noemí Cos Domingo, Mònica Majós Torró, Carlos |
| author2_role | author author author author author author author author |
| author_browse | Cos Domingo, Mònica Flores-Casaperalta, Susanie Majós Torró, Carlos Martínez Zalacaín, Ignacio Naval Baudin, Pablo Plans, Gerard Pons Escoda, Albert Vidal Sarró, Noemí Viveros, Mildred |
| author_facet | Pons Escoda, Albert Naval Baudin, Pablo Viveros, Mildred Flores-Casaperalta, Susanie Martínez Zalacaín, Ignacio Plans, Gerard Vidal Sarró, Noemí Cos Domingo, Mònica Majós Torró, Carlos |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Purpose The presurgical discrimination of IDH-mutant astrocytoma grade 4 from IDH-wildtype glioblastoma is crucial for patient management, especially in younger adults, aiding in prognostic assessment, guiding molecular diagnostics and surgical planning, and identifying candidates for IDH-targeted trials. Despite its potential, the full capabilities of DSC-PWI remain underexplored. This research evaluates the differentiation ability of relative-cerebral-blood-volume (rCBV) percentile values for the enhancing and non-enhancing tumor regions compared to the more commonly used mean or maximum preselected rCBV values. Methods This retrospective study, spanning 2016–2023, included patients under 55 years (age threshold based on World Health Organization recommendations) with grade 4 astrocytic tumors and known IDH status, who underwent presurgical MR with DSC-PWI. Enhancing and non-enhancing regions were 3D-segmented to calculate voxel-level rCBV, deriving mean, maximum, and percentile values. Statistical analyses were conducted using the Mann-Whitney U test and AUC-ROC. Results The cohort consisted of 59 patients (mean age 46; 34 male): 11 astrocytoma-4 and 48 glioblastoma. While glioblastoma showed higher rCBV in enhancing regions, the differences were not significant. However, non-enhancing astrocytoma-4 regions displayed notably higher rCBV, particularly in lower percentiles. The 30th rCBV percentile for non-enhancing regions was 0.705 in astrocytoma-4, compared to 0.458 in glioblastoma (p = 0.001, AUC-ROC = 0.811), outperforming standard mean and maximum values. Conclusion Employing an automated percentile-based approach for rCBV selection enhances differentiation capabilities, with non-enhancing regions providing more insightful data. Elevated rCBV in lower percentiles of non-enhancing astrocytoma-4 is the most distinguishable characteristic and may indicate lowly vascularized infiltrated edema, contrasting with glioblastoma’s pure edema. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_10d0f842d71cbbe0022c00a62da603ae |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:dnet:ubarcelona__::b70b7abdc793518a209c67785445eadc |
| publishDate | 2024 |
| publishDateSort | 2024 |
| publisher | Springer Verlag |
| publisherStr | Springer Verlag |
| reponame_str | Dipòsit Digital de la UB |
| spelling | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions Pons Escoda, Albert Naval Baudin, Pablo Viveros, Mildred Flores-Casaperalta, Susanie Martínez Zalacaín, Ignacio Plans, Gerard Vidal Sarró, Noemí Cos Domingo, Mònica Majós Torró, Carlos Imatges per ressonància magnètica Tumors cerebrals Magnetic resonance imaging Brain tumors Purpose The presurgical discrimination of IDH-mutant astrocytoma grade 4 from IDH-wildtype glioblastoma is crucial for patient management, especially in younger adults, aiding in prognostic assessment, guiding molecular diagnostics and surgical planning, and identifying candidates for IDH-targeted trials. Despite its potential, the full capabilities of DSC-PWI remain underexplored. This research evaluates the differentiation ability of relative-cerebral-blood-volume (rCBV) percentile values for the enhancing and non-enhancing tumor regions compared to the more commonly used mean or maximum preselected rCBV values. Methods This retrospective study, spanning 2016–2023, included patients under 55 years (age threshold based on World Health Organization recommendations) with grade 4 astrocytic tumors and known IDH status, who underwent presurgical MR with DSC-PWI. Enhancing and non-enhancing regions were 3D-segmented to calculate voxel-level rCBV, deriving mean, maximum, and percentile values. Statistical analyses were conducted using the Mann-Whitney U test and AUC-ROC. Results The cohort consisted of 59 patients (mean age 46; 34 male): 11 astrocytoma-4 and 48 glioblastoma. While glioblastoma showed higher rCBV in enhancing regions, the differences were not significant. However, non-enhancing astrocytoma-4 regions displayed notably higher rCBV, particularly in lower percentiles. The 30th rCBV percentile for non-enhancing regions was 0.705 in astrocytoma-4, compared to 0.458 in glioblastoma (p = 0.001, AUC-ROC = 0.811), outperforming standard mean and maximum values. Conclusion Employing an automated percentile-based approach for rCBV selection enhances differentiation capabilities, with non-enhancing regions providing more insightful data. Elevated rCBV in lower percentiles of non-enhancing astrocytoma-4 is the most distinguishable characteristic and may indicate lowly vascularized infiltrated edema, contrasting with glioblastoma’s pure edema. Springer Verlag https://hdl.handle.net/2445/228829 |
| spellingShingle | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions Pons Escoda, Albert Imatges per ressonància magnètica Tumors cerebrals Magnetic resonance imaging Brain tumors |
| status_str | publishedVersion |
| title | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| title_full | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| title_fullStr | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| title_full_unstemmed | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| title_short | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| title_sort | DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions |
| topic | Imatges per ressonància magnètica Tumors cerebrals Magnetic resonance imaging Brain tumors |
| topic_facet | Imatges per ressonància magnètica Tumors cerebrals Magnetic resonance imaging Brain tumors |
| url | https://hdl.handle.net/2445/228829 |