Comparison between Dynamic Contrast-Enhanced MRI and Dynamic Susceptibility Contrast MRI in Glioma Grading

Objective: To determine the usefulness of the dynamic contrast enhanced MRI (DCE-MRI) technique for differentiating between low grade glioma and high grade glioma and compare with dynamic susceptibility contrast (DSC) MRI. Methods: Conventional MRI, DCE-MRI and DSC-MRI were performed preoperatively in 17 patients with gliomas. Permeability indices (Ktrans, rKtrans, Ve and Kep) from DCE-MRI and cerebral blood volume (CBV), rCBV from DSC-MRI were quantified. The differences in Ktrans, rKtrans, Ve, Kep, CBV and rCBV between low grade glioma and high grade glioma were analyzed and compared. Receiver operating characteristic (ROC) curve analyses were conducted. Results: Ktrans, rKtrans, Ve, CBV and rCBV were significantly different between low grade glioma and high grade glioma (p = 0.001, 0.014, 0.02, 0.025, and 0.034, respectively). The areas under the ROC curve for Ktrans, rKtrans, Ve, rCBV and CBV were 0.986, 0.896, 0.829, 0.852, and 0.833, respectively. Ktrans was the best parameter for differentiating low grade glioma from high grade glioma with cutoff value of 0.0091 min-1 (sensitivity 100%, specificity 80%, PPV 87.5%, NPV 100%, accuracy 94.1%). Conclusion: DCE-MRI could be used to estimate neovascular permeability and for pre-operative grading of glioma. Among the perfusion parameters, Ktrans was the best parameter for differentiating low grade glioma from high grade glioma . DCE-MRI may be promising for better diagnostic performance than DSC-MRI