Early detection of malignant transformation in resected who II low-grade glioma using diffusion tensor-derived quantitative measures
Freitag MT, Maier-Hein KH, Binczyk F, Weber C, Bonekamp D, Tarnawski R, Bobek-Billewicz B, Polanska J, Majchrzak H, Stieltjes B, Laun FB (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 11
Article Number: e0164679
Journal Issue: 10
DOI: 10.1371/journal.pone.0164679
Abstract
Here, we retrospectively investigate the value of voxel-wisely plotted diffusion tensorderived (DTI) axial, radial and mean diffusivity for the early detection of malignant transformation (MT) in WHO II glioma compared to contrast-enhanced images. Materials and Methods Forty-seven patients underwent brain magnetic resonance imaging follow-up between 2006±2014 after gross-tumor resection of intra-axial WHO II glioma. Axial/Mean/Radial diffusivity maps (AD/MD/RD) were generated from DTI data. ADmin/MDmin/RDmin values were quantified within tumor regions-of-interest generated by two independent readers including tumor contrast-to-noise (CNR). Sensitivity/specificity and area-under-the-curve (AUC) were calculated using receiver-operating-characteristic analysis. Inter-reader agreement was assessed (Cohen's kappa). Results Eighteen patients demonstrated malignant transformation (MT) confirmed in 8/18 by histopathology and in 10/18 through imaging follow-up. Twelve of 18 patients (66.6%) with MT showed diffusion restriction timely coincidental with contrast-enhancement (CE). In the remaining six patients (33.3%), the diffusion restriction preceded the CE. The mean gain in detection time using DTI was (0.8±0.5 years, p = 0.028). Compared to MDmin and RDmin, ROC-analysis showed best diagnostic value for ADmin (sensitivity/specificity 94.94%/89.7%, AUC 0.96; p<0.0001) to detect MT. CNR was highest for AD (1.83±0.14), compared to MD (1.31±0.19; p<0.003) and RD (0.90±0.23; p<0.0001). Cohen's Kappa was 0.77 for ADmin, 0.71 for MDmin and 0.65 for RDmin (p<0.0001, respectively). Conclusion MT is detectable at the same time point or earlier compared to T1w-CE by diffusion restriction in diffusion-tensor-derived maps. AD demonstrated highest sensitivity/specificity/ tumor-contrast compared to radial or mean diffusivity (= apparent diffusion coefficient) to detect MT.
Authors with CRIS profile
Involved external institutions
Deutsches Krebsforschungszentrum (DKFZ)
Germany (DE)
Silesian University of Technology Gliwice
Poland (PL)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
Medical University of Silesia in Katowice / Śląski Uniwersytet Medyczny w Katowicach (SUM)
Poland (PL)
Germany (DE)
Silesian University of Technology Gliwice
Poland (PL)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
Medical University of Silesia in Katowice / Śląski Uniwersytet Medyczny w Katowicach (SUM)
Poland (PL)
How to cite
APA:
Freitag, M.T., Maier-Hein, K.H., Binczyk, F., Weber, C., Bonekamp, D., Tarnawski, R.,... Laun, F.B. (2016). Early detection of malignant transformation in resected who II low-grade glioma using diffusion tensor-derived quantitative measures. PLoS ONE, 11(10). https://doi.org/10.1371/journal.pone.0164679
MLA:
Freitag, Martin T., et al. "Early detection of malignant transformation in resected who II low-grade glioma using diffusion tensor-derived quantitative measures." PLoS ONE 11.10 (2016).
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