Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study

<b>Background/Objectives</b>: The non-invasive identification of glioma subtypes is useful for initial diagnosis, treatment planning, and follow-up. The aim of this study was to evaluate the performance of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced (DCE)-MRI in differ...

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Main Authors: Leonie Zerweck, Uwe Klose, Urs Würtemberger, Vivien Richter, Thomas Nägele, Georg Gohla, Kathrin Grundmann-Hauser, Arne Estler, Christer Ruff, Gunter Erb, Ulrike Ernemann, Till-Karsten Hauser
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Language:English
Published: MDPI AG 2025-02-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/532
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author Leonie Zerweck
Uwe Klose
Urs Würtemberger
Vivien Richter
Thomas Nägele
Georg Gohla
Kathrin Grundmann-Hauser
Arne Estler
Christer Ruff
Gunter Erb
Ulrike Ernemann
Till-Karsten Hauser
author_facet Leonie Zerweck
Uwe Klose
Urs Würtemberger
Vivien Richter
Thomas Nägele
Georg Gohla
Kathrin Grundmann-Hauser
Arne Estler
Christer Ruff
Gunter Erb
Ulrike Ernemann
Till-Karsten Hauser
author_sort Leonie Zerweck
collection DOAJ
description <b>Background/Objectives</b>: The non-invasive identification of glioma subtypes is useful for initial diagnosis, treatment planning, and follow-up. The aim of this study was to evaluate the performance of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced (DCE)-MRI in differentiating subtypes of adult-type diffuse gliomas. <b>Methods</b>: In a prospective multicenter study, standardized MRI was analyzed in 59 patients with adult-type diffuse glioma. DKI and DCE-MRI parameter values were quantitatively evaluated in ROIs of contrast-enhancing/solid tumor and four concentric shells of peritumoral tissue. The parameter means of glioblastomas, IDH wildtype; astrocytomas, IDH mutant; and oligodendrogliomas, IDH mutant were compared. Binary logistic regression analyses were performed to differentiate between IDH mutant and IDH wildtype gliomas and between IDH mutant astrocytomas and oligodendrogliomas. ROC curves were analyzed for each parameter and for combined regression. <b>Results</b>: Significant differences between the three aforementioned subtypes were found for the DKI and DCE-MRI parameters, depending on the distance to the tumor core. A combination of the parameters’ apparent diffusion coefficient (ADC) and fractional volume of extravascular extracellular space (ve) revealed the best prediction of IDH mutant vs. wildtype gliomas (AUC = 0.976 (0.943–1.000)) and astrocytomas vs. oligodendrogliomas (AUC = 0.840 (0.645–1.000)) with the lowest Akaike information criterion. <b>Conclusions</b>: The combined evaluation of DKI and DCE-MRI at different distances to the contrast-enhancing/solid tumor seems to be helpful in predicting glioma subtypes according to the WHO 2021 classification.
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spelling doaj-art-3156c9f070e44fb1a46b8fa2c22d67632025-08-20T02:59:14ZengMDPI AGDiagnostics2075-44182025-02-0115553210.3390/diagnostics15050532Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter StudyLeonie Zerweck0Uwe Klose1Urs Würtemberger2Vivien Richter3Thomas Nägele4Georg Gohla5Kathrin Grundmann-Hauser6Arne Estler7Christer Ruff8Gunter Erb9Ulrike Ernemann10Till-Karsten Hauser11Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyInstitute of Medical Genetics and Applied Genomics, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyBracco Group, Medical and Regulatory Affairs, 78467 Konstanz, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, 72076 Tuebingen, Germany<b>Background/Objectives</b>: The non-invasive identification of glioma subtypes is useful for initial diagnosis, treatment planning, and follow-up. The aim of this study was to evaluate the performance of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced (DCE)-MRI in differentiating subtypes of adult-type diffuse gliomas. <b>Methods</b>: In a prospective multicenter study, standardized MRI was analyzed in 59 patients with adult-type diffuse glioma. DKI and DCE-MRI parameter values were quantitatively evaluated in ROIs of contrast-enhancing/solid tumor and four concentric shells of peritumoral tissue. The parameter means of glioblastomas, IDH wildtype; astrocytomas, IDH mutant; and oligodendrogliomas, IDH mutant were compared. Binary logistic regression analyses were performed to differentiate between IDH mutant and IDH wildtype gliomas and between IDH mutant astrocytomas and oligodendrogliomas. ROC curves were analyzed for each parameter and for combined regression. <b>Results</b>: Significant differences between the three aforementioned subtypes were found for the DKI and DCE-MRI parameters, depending on the distance to the tumor core. A combination of the parameters’ apparent diffusion coefficient (ADC) and fractional volume of extravascular extracellular space (ve) revealed the best prediction of IDH mutant vs. wildtype gliomas (AUC = 0.976 (0.943–1.000)) and astrocytomas vs. oligodendrogliomas (AUC = 0.840 (0.645–1.000)) with the lowest Akaike information criterion. <b>Conclusions</b>: The combined evaluation of DKI and DCE-MRI at different distances to the contrast-enhancing/solid tumor seems to be helpful in predicting glioma subtypes according to the WHO 2021 classification.https://www.mdpi.com/2075-4418/15/5/532gliomaglioblastomaastrocytomaoligodendrogliomadiffusion kurtosis imagingdynamic contrast-enhanced MRI
spellingShingle Leonie Zerweck
Uwe Klose
Urs Würtemberger
Vivien Richter
Thomas Nägele
Georg Gohla
Kathrin Grundmann-Hauser
Arne Estler
Christer Ruff
Gunter Erb
Ulrike Ernemann
Till-Karsten Hauser
Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
Diagnostics
glioma
glioblastoma
astrocytoma
oligodendroglioma
diffusion kurtosis imaging
dynamic contrast-enhanced MRI
title Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
title_full Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
title_fullStr Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
title_full_unstemmed Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
title_short Preoperative Adult-Type Diffuse Glioma Subtype Prediction with Dynamic Contrast-Enhanced MR Imaging and Diffusion Weighted Imaging in Tumor Cores and Peritumoral Tissue—A Standardized Multicenter Study
title_sort preoperative adult type diffuse glioma subtype prediction with dynamic contrast enhanced mr imaging and diffusion weighted imaging in tumor cores and peritumoral tissue a standardized multicenter study
topic glioma
glioblastoma
astrocytoma
oligodendroglioma
diffusion kurtosis imaging
dynamic contrast-enhanced MRI
url https://www.mdpi.com/2075-4418/15/5/532
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