Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas: a multicenter study in Japan

Kazufumi Kikuchi, Akio Hiwatashi, Osamu Togao, Koji Yamashita, Ryotaro Kamei, Mika Kitajima, Masafumi Kanoto, Hiroto Takahashi, Yusuke Uchiyama, Masafumi Harada, Yuki Shinohara, Takashi Yoshiura, Yuki Wakata, Hiroshi Honda

Research output: Contribution to journalArticle

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Abstract

Purpose: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. Methods: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P <.05 was considered to indicate significance. Results: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P <.0001, P =.0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10−3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3 mm2/s) (P <.0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. Conclusion: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.

Original languageEnglish
Pages (from-to)391-401
Number of pages11
JournalNeuroradiology
Volume60
Issue number4
DOIs
Publication statusPublished - Apr 1 2018

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Astrocytoma
ROC Curve
Glioma
Multicenter Studies
Cerebrovascular Circulation
Japan
Perfusion
Hydrocephalus
Edema
Neoplasms
Hemorrhage
Cerebral Blood Volume

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas : a multicenter study in Japan. / Kikuchi, Kazufumi; Hiwatashi, Akio; Togao, Osamu; Yamashita, Koji; Kamei, Ryotaro; Kitajima, Mika; Kanoto, Masafumi; Takahashi, Hiroto; Uchiyama, Yusuke; Harada, Masafumi; Shinohara, Yuki; Yoshiura, Takashi; Wakata, Yuki; Honda, Hiroshi.

In: Neuroradiology, Vol. 60, No. 4, 01.04.2018, p. 391-401.

Research output: Contribution to journalArticle

Kikuchi, K, Hiwatashi, A, Togao, O, Yamashita, K, Kamei, R, Kitajima, M, Kanoto, M, Takahashi, H, Uchiyama, Y, Harada, M, Shinohara, Y, Yoshiura, T, Wakata, Y & Honda, H 2018, 'Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas: a multicenter study in Japan', Neuroradiology, vol. 60, no. 4, pp. 391-401. https://doi.org/10.1007/s00234-018-1991-7
Kikuchi, Kazufumi ; Hiwatashi, Akio ; Togao, Osamu ; Yamashita, Koji ; Kamei, Ryotaro ; Kitajima, Mika ; Kanoto, Masafumi ; Takahashi, Hiroto ; Uchiyama, Yusuke ; Harada, Masafumi ; Shinohara, Yuki ; Yoshiura, Takashi ; Wakata, Yuki ; Honda, Hiroshi. / Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas : a multicenter study in Japan. In: Neuroradiology. 2018 ; Vol. 60, No. 4. pp. 391-401.
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abstract = "Purpose: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. Methods: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P <.05 was considered to indicate significance. Results: Intratumoral hemorrhage and calcification were observed in 10.0{\%} and 21.7{\%} of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P <.0001, P =.0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10−3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3 mm2/s) (P <.0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. Conclusion: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.",
author = "Kazufumi Kikuchi and Akio Hiwatashi and Osamu Togao and Koji Yamashita and Ryotaro Kamei and Mika Kitajima and Masafumi Kanoto and Hiroto Takahashi and Yusuke Uchiyama and Masafumi Harada and Yuki Shinohara and Takashi Yoshiura and Yuki Wakata and Hiroshi Honda",
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T1 - Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas

T2 - a multicenter study in Japan

AU - Kikuchi, Kazufumi

AU - Hiwatashi, Akio

AU - Togao, Osamu

AU - Yamashita, Koji

AU - Kamei, Ryotaro

AU - Kitajima, Mika

AU - Kanoto, Masafumi

AU - Takahashi, Hiroto

AU - Uchiyama, Yusuke

AU - Harada, Masafumi

AU - Shinohara, Yuki

AU - Yoshiura, Takashi

AU - Wakata, Yuki

AU - Honda, Hiroshi

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Purpose: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. Methods: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P <.05 was considered to indicate significance. Results: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P <.0001, P =.0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10−3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3 mm2/s) (P <.0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. Conclusion: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.

AB - Purpose: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. Methods: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P <.05 was considered to indicate significance. Results: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P <.0001, P =.0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10−3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3 mm2/s) (P <.0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. Conclusion: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.

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