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Quantitative vs. semiquantitative assessment of intratumoral susceptibility signals in patients with different grades of glioma.

不同级别胶质瘤患者瘤内易感性信号的定量与半定量评估。

  • 影响因子:3.96
  • DOI:10.1002/jmri.26786
  • 作者列表:"Bhattacharjee R","Gupta RK","Patir R","Vaishya S","Ahlawat S","Singh A
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Susceptibility weighted imaging (SWI) provides vascular information and plays an important role in improving the diagnostic accuracy of preoperative glioma grading. Intratumoral susceptibility signal intensities (ITSS) obtained from SWI has been used in glioma grading. However, the current method for estimation of ITSS is semiquantitative, manual count-dependent, and includes hemorrhage as well as vasculature. PURPOSE:To develop a quantitative approach that calculates the vasculature volume within tumors by filtering out the hemorrhage from ITSS using R2 * values and connected component analysis-based segmentation algorithm; to evaluate the accuracy of the proposed ITSS vasculature volume (IVV) for differentiating various grades of glioma; and compare it with reported semiquantitative ITSS approach. STUDY TYPE:Retrospective. SUBJECTS:Histopathologically confirmed 41 grade IV, 19 grade III, and 15 grade II glioma patients.Field Strength/Sequence: SWI (four echoes: 5.6, 11.8, 18, 24.2 msec) along with conventional MRI sequences (T2 -weighted, T1 -weighted, 3D-fluid-attenuated inversion recovery [FLAIR], and diffusion-weighted imaging [DWI]) at 3.0T. ASSESSMENT:R2 * relaxation maps were calculated from multiecho SWI. The R2 * cutoff value for hemorrhage ITSS was determined. A segmentation algorithm was designed, based on this R2 * hemorrhage combined with connected component shape analysis, to quantify the IVV from all slices containing tumor by filtering out hemorrhages. Semiquantitative ITSS scoring as well as total ITSS volume (TIV) including hemorrhages were also calculated. STATISTICAL TESTS:One-way analysis of variance (ANOVA) and Tukey-Kramer post-hoc tests were performed to see the difference among the three grades of the tumor (II, III, and IV) in terms of semiquantitative ITSS scoring, TIV, and IVV. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the three methods individually in discriminating between grades of glioma. RESULTS:One-way ANOVA showed that only the proposed IVV significantly differentiated different grades of gliomas having visible ITSS. ROC analysis showed that IVV provided the highest AUC for the discrimination of grade II vs. III (0.93), grade III vs. IV (0.98), and grade II vs. IV glioma (0.94). IVV also provided the highest sensitivity and specificity for differentiating grade II vs. III (87.44, 98.41), grade III vs. IV (97.15, 94.12), and grade II vs. IV (98.72, 92.31). DATA CONCLUSION:The proposed quantitative method segregates hemorrhage from tumor vasculature. It scores above the existing semiquantitative method in terms of ITSS estimation and grading accuracy. LEVEL OF EVIDENCE:4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:225-233.

摘要

背景: 磁敏感加权成像 (SWI) 提供了血管信息,对提高术前胶质瘤分级的诊断准确性具有重要作用。从 SWI 获得的瘤内敏感性信号强度 (ITSS) 已用于胶质瘤分级。然而,目前估计 ITSS 的方法是半定量的,手工计数依赖的,包括出血和脉管系统。 目的: 开发一种定量方法,通过使用 R2 * 值和基于连接成分分析的分割算法从 ITSS 中过滤出出血来计算肿瘤内的脉管系统体积; 评价提出的 ITSS 脉管体积 (IVV) 鉴别不同级别胶质瘤的准确性; 并与报道的半定量 ITSS 方法进行比较。 研究类型: 回顾性。 研究对象: 经组织病理学证实的 41 例 ⅳ 级、 19 例 ⅲ 级、 15 例 ⅱ 级胶质瘤患者。场强/序列: SWI (四个回波: 5.6 、 11.8 、 18 、 24.2 毫秒) 以及常规 MRI 序列 (T2 加权、 T1 加权、 3d-fluid 衰减反转恢复 [FLAIR], 和扩散加权成像 [DWI]) 在 3.0 T。 评估: 根据多回波 SWI 计算 R2 * 松弛图。测定出血 ITSS 的 R2 * 临界值。设计了一种分割算法,基于这种 R2 * 出血结合连接成分形状分析,通过过滤出血来量化所有包含肿瘤的切片的 IVV。还计算了半定量 ITSS 评分和总 ITSS 体积 (TIV),包括出血。 统计学检验: 进行单因素方差分析 (ANOVA) 和 Tukey-Kramer 事后检验,以观察肿瘤三个等级之间的差异 (II 、 III 、和 IV) 半定量 ITSS 评分、 TIV 和 IVV。采用受试者工作特征 (ROC) 曲线分析评价三种方法在胶质瘤分级鉴别中的性能。 结果: 单因素方差分析显示,只有拟定的 IVV 显著分化不同级别的胶质瘤具有可见的 ITSS。ROC 分析显示,IVV 为 ⅱ 级 vs.Ⅲ 级 (0.93) 、 ⅲ 级 vs.Ⅳ 级 (0.98) 和 ⅱ 级 vs.Ⅳ 级 (0.94) 胶质瘤的判别提供了最高的 AUC。IVV 还提供了区分 II 级与 III 级 (87.44,98.41) 、 III 级与 IV 级 (97.15,94.12) 和 II 级与 IV 级 (98.72, 92.31)。 数据结论: 所提出的定量方法将出血与肿瘤血管分离。它在 ITSS 估计和分级精度方面的得分高于现有的半定量方法。 证据级别: 4 技术功效: 阶段 2 J。Magn.雷森。成像 2020; 51: 225-233。

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翻译标题与摘要 下载文献
影响因子:3.96
发表时间:2020-01-01
DOI:10.1002/jmri.26786
作者列表:["Bhattacharjee R","Gupta RK","Patir R","Vaishya S","Ahlawat S","Singh A"]

METHODS:BACKGROUND:Susceptibility weighted imaging (SWI) provides vascular information and plays an important role in improving the diagnostic accuracy of preoperative glioma grading. Intratumoral susceptibility signal intensities (ITSS) obtained from SWI has been used in glioma grading. However, the current method for estimation of ITSS is semiquantitative, manual count-dependent, and includes hemorrhage as well as vasculature. PURPOSE:To develop a quantitative approach that calculates the vasculature volume within tumors by filtering out the hemorrhage from ITSS using R2 * values and connected component analysis-based segmentation algorithm; to evaluate the accuracy of the proposed ITSS vasculature volume (IVV) for differentiating various grades of glioma; and compare it with reported semiquantitative ITSS approach. STUDY TYPE:Retrospective. SUBJECTS:Histopathologically confirmed 41 grade IV, 19 grade III, and 15 grade II glioma patients.Field Strength/Sequence: SWI (four echoes: 5.6, 11.8, 18, 24.2 msec) along with conventional MRI sequences (T2 -weighted, T1 -weighted, 3D-fluid-attenuated inversion recovery [FLAIR], and diffusion-weighted imaging [DWI]) at 3.0T. ASSESSMENT:R2 * relaxation maps were calculated from multiecho SWI. The R2 * cutoff value for hemorrhage ITSS was determined. A segmentation algorithm was designed, based on this R2 * hemorrhage combined with connected component shape analysis, to quantify the IVV from all slices containing tumor by filtering out hemorrhages. Semiquantitative ITSS scoring as well as total ITSS volume (TIV) including hemorrhages were also calculated. STATISTICAL TESTS:One-way analysis of variance (ANOVA) and Tukey-Kramer post-hoc tests were performed to see the difference among the three grades of the tumor (II, III, and IV) in terms of semiquantitative ITSS scoring, TIV, and IVV. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the three methods individually in discriminating between grades of glioma. RESULTS:One-way ANOVA showed that only the proposed IVV significantly differentiated different grades of gliomas having visible ITSS. ROC analysis showed that IVV provided the highest AUC for the discrimination of grade II vs. III (0.93), grade III vs. IV (0.98), and grade II vs. IV glioma (0.94). IVV also provided the highest sensitivity and specificity for differentiating grade II vs. III (87.44, 98.41), grade III vs. IV (97.15, 94.12), and grade II vs. IV (98.72, 92.31). DATA CONCLUSION:The proposed quantitative method segregates hemorrhage from tumor vasculature. It scores above the existing semiquantitative method in terms of ITSS estimation and grading accuracy. LEVEL OF EVIDENCE:4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:225-233.

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