Article Figures & Data
Figures
- Fig 1.
A 62-year-old man with biopsy-proved grade IV glioma. An example of how the ROIs in which minimum ADC (A) and maximum rCBV (B) have been measured is provided.
- Fig 2.
Boxplots show the range of maximum rCBV values determined by using DSC perfusion imaging in 162 patients with diffuse gliomas distributed by tumor histology and grade. The box represents the interquartile range (ie, 25%–75%); and black bar, the median. Th perfusion difference between grade II and III tumors was not statistically significant.
- Fig 3.
Boxplots show the range of minimum ADC values of 162 diffuse gliomas distributed by tumor histology and grade. The box represents the interquartile range (ie, 25%–75%); and the black bar, the median. Differences in minimum ADC values were statistically significant among grade II, III, and IV gliomas (P < .001). However, if we consider astrocytomas, oligodendrogliomas, and oligoastrocytomas separately, grades II and III oligodendrogliomas and grades III and IV oligoastrocytomas were not significantly different in ADC values.
- Fig 4.
ROC curve analysis showing the effect of using rCBV (A) and ADC (B) as individual or combined (C) variables in differentiating high- and low-grade gliomas. The area under the ROC curve for the maximum rCBV, minimum ADC, and a combination of both parameters is 0.72; 0.75; and 0.83, respectively.
Tables
Histology Grade II Grade III Grade IV Total Astrocytomas 18 (15.1%) 9 (7.6%) 92 (77.3%) (GBM) 119 (73.5%) Oligodendrogliomas 10 (37.03%) 17 (62.97%) 27 (16.7%) Oligoastrocytomas 4 (25%) 3 (18.8%) 9 (56.3%) (GBM-O) 16 (9.9%) Total 32 (19.8%) 29 (17.9%) 101 (62.3%) 162 (100%) Type and Grade Max rCBV (Mean) Min ADC (Mean)(× 10−3 mm2/s) Astrocytomas Grade II 2.11 ± 1.58 1.2731 ± 0.293 Grade III 2.15 ± 0.71 1.0673 ± 0.276a Grade IV 6.92 ± 3.12a,b 0.7456 ± 0.135a,b Oligodendrogliomas Grade II 2.98 ± 1.30 1.0827 ± 0.195 Grade III 4.36 ± 2.80 0.9326 ± 0.199 Oligoastrocytomas Grade II 1.98 ± 0.63 1.2925 ± 0.300 Grade III 5.30 ± 4.34 0.8410 ± 0.367a Grade IV 6.30 ± 2.97 0.7651 ± 0.768a - Table 3:
Sensitivity, specificity, PPV, and NPV for rCBV, ADC, and their combination in the differentiation of high-grade from low-grade gliomas
Sensitivity Specificity PPV NPV Max rCBV ≥ 1.74 94.4% 50.0% 88% 69.6% Min ADC ≤ 1.185 97.6% 53.1% 89% 85% Max rCBV ≥ 1.74 OR Min ADC ≤ 1.185 98.4% 31.3% 84.7% 83.3% Max rCBV ≥ 1.74 AND Min ADC ≤ 1.185 93.5% 71.9% 92.8% 74.2% -
Note:—PPV indicates positive predictive value; NPV, negative predictive value; Max, maximum; Min, minimum.
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