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Research ArticleBrain

Histogram Analysis of MR Imaging–Derived Cerebral Blood Volume Maps: Combined Glioma Grading and Identification of Low-Grade Oligodendroglial Subtypes

K.E. Emblem, D. Scheie, P. Due-Tonnessen, B. Nedregaard, T. Nome, J.K. Hald, K. Beiske, T.R. Meling and A. Bjornerud
American Journal of Neuroradiology October 2008, 29 (9) 1664-1670; DOI: https://doi.org/10.3174/ajnr.A1182
K.E. Emblem
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D. Scheie
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P. Due-Tonnessen
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B. Nedregaard
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T. Nome
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J.K. Hald
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K. Beiske
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T.R. Meling
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A. Bjornerud
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  • Fig 1.
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    Fig 1.

    A, Axial T2-weighted fast spin-echo (FSE) image (TR/TE, 4000/104 ms) of a patient (subject 3) with a low-grade oligoastrocytoma without LOH on 1p/19q. B, Axial postcontrast T1-weighted spin-echo (SE) image (TR/TE, 500/7.7 ms) of subject 3. C, Coregistered rCBV map of subject 3. D, Axial T2-weighted FSE image (TR/TE, 4000/104 ms) of a patient (subject 7) with a low-grade oligoastrocytoma with LOH on 1p/19q. E, Axial postcontrast T1-weighted SE image (TR/TE, 500/7.7 ms) of subject 7. F, Coregistered rCBV map of subject 7. Note the low rCBV values in the tumor area in image C compared with the tumor area in image F, typical of low-grade oligodendroglial tumors without LOH on 1p/19q. The corresponding normalized histogram signatures are shown in Fig 2.

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    Fig 2.

    Resulting normalized histogram plots of the total distribution of rCBV values from the patients shown in Fig 1. The higher peak height of the low-grade oligoastrocytoma without LOH on p/19q, shown in a dotted line (subject 3, Fig 1A–C), indicates a more homogeneous rCBV distribution than the rCBV distribution of a low-grade oligoastrocytoma with LOH on 1p/19q, shown in a solid line (subject 7, Fig 1D–F).

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    Fig 3.

    Mean histogram peak heights with SEs of the mean for the different glioma types investigated. The values are as follows: HGG = 0.052 (0.004), LGG = 0.094 (0.004), all high-grade oligodendroglial tumors (HGO) = 0.068 (0.010), low-grade oligodendroglial tumor with LOH on 1p/19q (LGO[−]) = 0.096 (0.004), low-grade oligodendroglial tumor without LOH on 1p/19q (LGO[+]) = 0.113 (0.002), and low-grade diffuse astrocytoma (LGA) = 0.086 (0.012). The oligodendroglial tumors include both oligodendrogliomas and oligoastrocytomas.

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    Fig 4.

    A scatterplot showing histogram peak heights for the 52 patients included in our study. The histogram method is able to significantly differentiate between HGGs (▴) and LGGs (+) (P < .001), with an ICC of 0.902.

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    Fig 5.

    Histogram peak heights for the 52 patients investigated in our study (23 LGGs and 29 HGGs). Each histogram peak height is a mean value across the 4 observers. With a cutoff value of 0.107, the sensitivity and specificity when distinguishing the 6 patients with low-grade oligodendroglial tumors without LOH on 1p/19q (red bars) from the other 46 patients (blue bars) are 100% (6/6) and 91% (42/46), respectively.

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    Fig 6.

    ROC curve for the histogram method when distinguishing patients with low-grade oligodendroglial tumors without LOH on 1p/19q (n = 6) from the other gliomas (n = 46). The area (±SE) under the ROC curve is Az = 0.931 ± .036.

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  • Patient demographics, histologic features, surgical procedure, and MR imaging findings for patients diagnosed with oligodendroglial tumors

    SubjectAge (yr)SexHDWHO GradeLOH on 1p/19qClassic HistologySurgical ProcedureContrast EnhancementHistogram Peak Heights*
    162FODIIYesYesResectionNone0.120
    236FOAIIYesNoResectionNone0.095
    328MOAIINoNoBiopsyNone0.118
    463MAODIIIYesYesResectionModerate0.075
    554MAODIIIYesYesResectionModerate0.024
    654MODIIYesYesBiopsyNone0.091
    744FOAIIYesNoResectionNone0.093
    844MOAIINoNoResectionNone0.109
    940FOAIINoNoResectionExtensive0.108
    1037FODIIYesYesBiopsyNone0.070
    1137FOAIINoNoResectionNone0.108
    1230FOAIIYesYesResectionNone0.095
    1359MAODIIINoNoBiopsyExtensive0.109
    1431FODIIYesYesResectionNone0.100
    1551MAOAIIINoNoResectionNone0.081
    1629FAOAIIINoNoResectionModerate0.045
    1771MAOAIIINoNoResectionModerate0.069
    1863MAOAIIINoNoResectionModerate0.070
    1947MOAIIYesNoBiopsyModerate0.093
    2043FOAIINoNoResectionNone0.116
    2164MODIIYesYesBiopsyNone0.105
    2238MOAIINoNoResectionNone0.122
    • Note:—HD indicates histopathologic diagnosis; OA, oligoastrocytoma; OD, oligodendroglioma; AOD, anaplastic oligodendroglioma; AOA. anaplastic oligoastrocytoma; LOH, loss of heterozygosity.

    • * The histogram peak height is in units of relative frequency between 0–1.

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American Journal of Neuroradiology
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K.E. Emblem, D. Scheie, P. Due-Tonnessen, B. Nedregaard, T. Nome, J.K. Hald, K. Beiske, T.R. Meling, A. Bjornerud
Histogram Analysis of MR Imaging–Derived Cerebral Blood Volume Maps: Combined Glioma Grading and Identification of Low-Grade Oligodendroglial Subtypes
American Journal of Neuroradiology Oct 2008, 29 (9) 1664-1670; DOI: 10.3174/ajnr.A1182

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Histogram Analysis of MR Imaging–Derived Cerebral Blood Volume Maps: Combined Glioma Grading and Identification of Low-Grade Oligodendroglial Subtypes
K.E. Emblem, D. Scheie, P. Due-Tonnessen, B. Nedregaard, T. Nome, J.K. Hald, K. Beiske, T.R. Meling, A. Bjornerud
American Journal of Neuroradiology Oct 2008, 29 (9) 1664-1670; DOI: 10.3174/ajnr.A1182
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