The aim was to explore the performance of dynamic contrast-enhanced (DCE) MRI and diffusion kurtosis imaging (DKI) in differentiating the molecular subtypes of adult-type gliomas. A multicenter MRI study with standardized imaging protocols, including DCE-MRI and DKI data of 81 patients with WHO grade 2–4 gliomas, was performed at six centers. The DCE-MRI and DKI parameter values were quantitatively evaluated in ROIs in tumor tissue and contralateral normal-appearing white matter. Binary logistic regression analyses were performed to differentiate between high-grade (HGG) vs. low-grade gliomas (LGG), IDH1/2 wildtype vs. mutated gliomas, and high-grade astrocytic tumors vs. high-grade oligodendrogliomas. Receiver operating characteristic (ROC) curves were generated for each parameter and for the regression models to determine the area under the curve (AUC), sensitivity, and specificity. Significant differences between tumor groups were found in the DCE-MRI and DKI parameters. A combination of DCE-MRI and DKI parameters revealed the best prediction of HGG vs. LGG (AUC = 0.954 (0.900–1.000)), IDH1/2 wildtype vs. mutated gliomas (AUC = 0.802 (0.702–0.903)), and astrocytomas/glioblastomas vs. oligodendrogliomas (AUC = 0.806 (0.700–0.912)) with the lowest Akaike information criterion. The combination of DCE-MRI and DKI seems helpful in predicting glioma types according to the 2021 World Health Organization’s (WHO) classification.
本研究旨在探讨动态对比增强磁共振成像（DCE-MRI）与扩散峰度成像（DKI）在鉴别成人型胶质瘤分子亚型中的效能。我们在六个中心开展了一项多中心MRI研究，采用标准化成像方案，收集了81例WHO 2-4级胶质瘤患者的DCE-MRI和DKI数据。在肿瘤组织及对侧表现正常的白质区域划定感兴趣区，对DCE-MRI和DKI参数值进行定量评估。通过二元逻辑回归分析区分高级别胶质瘤与低级别胶质瘤、IDH1/2野生型与突变型胶质瘤，以及高级别星形细胞瘤与高级别少突胶质细胞瘤。绘制各参数及回归模型的受试者工作特征曲线，计算曲线下面积、敏感度及特异度。结果显示不同肿瘤组间在DCE-MRI和DKI参数上存在显著差异。DCE-MRI与DKI参数联合应用对以下分型具有最佳预测效能：高级别与低级别胶质瘤（AUC=0.954（0.900-1.000））、IDH1/2野生型与突变型胶质瘤（AUC=0.802（0.702-0.903））、星形细胞瘤/胶质母细胞瘤与少突胶质细胞瘤（AUC=0.806（0.700-0.912）），且赤池信息准则值最低。研究表明，DCE-MRI与DKI联合应用有助于依据2021年世界卫生组织分类标准预测胶质瘤类型。
肿瘤(癌症)患者之家