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Di Ieva A. Computational Fractal-Based Analysis of MR Susceptibility-Weighted Imaging (SWI) in Neuro-Oncology and Neurotraumatology. ADVANCES IN NEUROBIOLOGY 2024; 36:445-468. [PMID: 38468047 DOI: 10.1007/978-3-031-47606-8_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Susceptibility-weighted imaging (SWI) is a magnetic resonance imaging (MRI) technique able to depict the magnetic susceptibility produced by different substances, such as deoxyhemoglobin, calcium, and iron. The main application of SWI in clinical neuroimaging is detecting microbleedings and venous vasculature. Quantitative analyses of SWI have been developed over the last few years, aimed to offer new parameters, which could be used as neuroimaging biomarkers. Each technique has shown pros and cons, but no gold standard exists yet. The fractal dimension (FD) has been investigated as a novel potential objective parameter for monitoring intratumoral space-filling properties of SWI patterns. We showed that SWI patterns found in different tumors or different glioma grades can be represented by a gradient in the fractal dimension, thereby enabling each tumor to be assigned a specific SWI fingerprint. Such results were especially relevant in the differentiation of low-grade versus high-grade gliomas, as well as from high-grade gliomas versus lymphomas.Therefore, FD has been suggested as a potential image biomarker to analyze intrinsic neoplastic architecture in order to improve the differential diagnosis within clinical neuroimaging, determine appropriate therapy, and improve outcome in patients.These promising preliminary findings could be extended into the field of neurotraumatology, by means of the application of computational fractal-based analysis for the qualitative and quantitative imaging of microbleedings in traumatic brain injury patients. In consideration of some evidences showing that SWI signals are correlated with trauma clinical severity, FD might offer some objective prognostic biomarkers.In conclusion, fractal-based morphometrics of SWI could be further investigated to be used in a complementary way with other techniques, in order to form a holistic understanding of the temporal evolution of brain tumors and follow-up response to treatment, with several further applications in other fields, such as neurotraumatology and cerebrovascular neurosurgery as well.
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Affiliation(s)
- Antonio Di Ieva
- Computational NeuroSurgery (CNS) Lab & Macquarie Neurosurgery, Macquarie Medical School, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, NSW, Australia.
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Yang X, Lin Y, Xing Z, She D, Su Y, Cao D. Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas. Acta Radiol 2021; 62:1657-1665. [PMID: 33222488 DOI: 10.1177/0284185120973624] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH)-mutant lower-grade gliomas (LGGs) are further classified into two classes: with and without 1p/19q codeletion. IDH-mutant and 1p/19q codeleted LGGs have better prognosis compared with IDH-mutant and 1p/19q non-codeleted LGGs. PURPOSE To evaluate conventional magnetic resonance imaging (cMRI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) for predicting 1p/19q codeletion status of IDH-mutant LGGs. MATERIAL AND METHODS We retrospectively reviewed cMRI, DWI, SWI, and DSC-PWI in 142 cases of IDH mutant LGGs with known 1p/19q codeletion status. Features of cMRI, relative ADC (rADC), intratumoral susceptibility signals (ITSSs), and the value of relative cerebral blood volume (rCBV) were compared between IDH-mutant LGGs with and without 1p/19q codeletion. Receiver operating characteristic curve and logistic regression were used to determine diagnostic performances. RESULTS IDH-mutant and 1p/19q non-codeleted LGGs tended to present with the T2/FLAIR mismatch sign and distinct borders (P < 0.001 and P = 0.038, respectively). Parameters of rADC, ITSSs, and rCBVmax were significantly different between the 1p/19q codeleted and 1p/19q non-codeleted groups (P < 0.001, P = 0.017, and P < 0.001, respectively). A combination of cMRI, SWI, DWI, and DSC-PWI for predicting 1p/19q codeletion status in IDH-mutant LGGs resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and an AUC of 80.36%, 78.57%, 83.30%, 75.00%, and 0.88, respectively. CONCLUSION 1p/19q codeletion status of IDH-mutant LGGs can be stratified using cMRI and advanced MRI techniques, including DWI, SWI, and DSC-PWI. A combination of cMRI, rADC, ITSSs, and rCBVmax may improve the diagnostic performance for predicting 1p/19q codeletion status.
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Affiliation(s)
- Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Yu Lin
- Department of Radiology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, PR China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Yan Su
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
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Lin Y, Xing Z, She D, Yang X, Zheng Y, Xiao Z, Wang X, Cao D. IDH mutant and 1p/19q co-deleted oligodendrogliomas: tumor grade stratification using diffusion-, susceptibility-, and perfusion-weighted MRI. Neuroradiology 2017; 59:555-562. [PMID: 28474187 PMCID: PMC5446560 DOI: 10.1007/s00234-017-1839-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 04/18/2017] [Indexed: 12/24/2022]
Abstract
Purpose Currently, isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion are proven diagnostic biomarkers for both grade II and III oligodendrogliomas (ODs). Non-invasive diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) are widely used to provide physiological information (cellularity, hemorrhage, calcifications, and angiogenesis) of neoplastic histology and tumor grade. However, it is unclear whether DWI, SWI, and DSC-PWI are able to stratify grades of IDH-mutant and 1p/19q co-deleted ODs. Methods We retrospectively reviewed the conventional MRI (cMRI), DWI, SWI, and DSC-PWI obtained on 33 patients with IDH-mutated and 1p/19q co-deleted ODs. Features of cMRI, normalized ADC (nADC), intratumoral susceptibility signals (ITSSs), normalized maxim CBV (nCBV), and normalized maximum CBF (nCBF) were compared between low-grade ODs (LGOs) and high-grade ODs (HGOs). Receiver operating characteristic curve and logistic regression were applied to determine diagnostic performances. Results HGOs tended to present with prominent edema and enhancement. nADC, ITSSs, nCBV, and nCBF were significantly different between groups (all P < 0.05). The combination of SWI and DSC-PWI for grading resulted in sensitivity and specificity of 100.00 and 93.33%, respectively. Conclusions IDH-mutant and 1p/19q co-deleted ODs can be stratified by grades using cMRI and advanced magnetic resonance imaging techniques including DWI, SWI, and DSC-PWI. Combined ITSSs with nCBV appear to be a promising option for grading molecularly defined ODs in clinical practice.
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Affiliation(s)
- Yu Lin
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Yingyan Zheng
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Zebin Xiao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Xingfu Wang
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China.
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Li X, Zhu Y, Kang H, Zhang Y, Liang H, Wang S, Zhang W. Glioma grading by microvascular permeability parameters derived from dynamic contrast-enhanced MRI and intratumoral susceptibility signal on susceptibility weighted imaging. Cancer Imaging 2015; 15:4. [PMID: 25889239 PMCID: PMC4389664 DOI: 10.1186/s40644-015-0039-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 02/25/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Dynamic contrast-enhanced MRI (DCE-MRI) estimates vascular permeability of brain tumors, and susceptibility-weighted imaging (SWI) may demonstrate tumor vascularity by intratumoral susceptibility signals (ITSS). This study assessed volume transfer constant (Ktrans) accuracy, the volume of extravascular extracellular space (EES) per unit volume of tissue (Ve) derived from DCE-MRI, and the degree of ITSS in glioma grading. METHODS Thirty-two patients with different glioma grades were enrolled in this retrospective study. Patients underwent DCE-MRI and non-contrast enhanced SWI by three-tesla scanning. Ktrans values, Ve, and the degree of ITSS in glioma were compared. Receiver operating characteristic (ROC) curve analysis determined diagnostic performances of Ktrans and Ve in glioma grading, and Spearman's correlation analysis determined the associations between Ktrans, Ve, ITSS, and tumor grade. RESULTS Ktrans and Ve values were significantly different between low grade gliomas (LGGs) and both high grade gliomas (HGGs) and grade II, III and IV gliomas (P<0.01). The degree of ITSS of LGGs was lower than HGGs (P<0.01), and the ITSS of grade II gliomas was lower than grade III or IV gliomas. Ktrans and Ve were correlated with glioma grade (P<0.01), while ITSS was moderately correlated (P<0.01). Ktrans values were moderately correlated with ITSS in the same segments (P<0.01). CONCLUSION Ktrans and Ve values, and ITSS helped distinguish the differences between LGGs and HGGs and between grade II, III and IV gliomas. There was a moderate correlation between Ktrans and ITSS in the same tumor segments.
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Affiliation(s)
- Xiaoguang Li
- Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
| | - Yongshan Zhu
- Department of Radiology, Tianchang people's hospital, Tianchang, Anhui, 239300, China.
| | - Houyi Kang
- Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
| | - Yulong Zhang
- Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
| | - Huaping Liang
- State key laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, No. 10, Changjiang Zhilu, Da Ping, Yuzhong Distriction, Chongqing, 400042, China.
| | - Sumei Wang
- Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA19104, USA.
| | - Weiguo Zhang
- Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. .,State key laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, No. 10, Changjiang Zhilu, Da Ping, Yuzhong Distriction, Chongqing, 400042, China.
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Di Ieva A, Göd S, Grabner G, Grizzi F, Sherif C, Matula C, Tschabitscher M, Trattnig S. Three-dimensional susceptibility-weighted imaging at 7 T using fractal-based quantitative analysis to grade gliomas. Neuroradiology 2012; 55:35-40. [PMID: 22903580 DOI: 10.1007/s00234-012-1081-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 07/27/2012] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Susceptibility-weighted imaging (SWI) with high- and ultra-high-field magnetic resonance is a very helpful tool for evaluating brain gliomas and intratumoral structures, including microvasculature. Here, we test whether objective quantification of intratumoral SWI patterns by applying fractal analysis can offer reliable indexes capable of differentiating glial tumor grades. METHODS Thirty-six patients affected by brain gliomas (grades II-IV, according to the WHO classification system) underwent MRI at 7 T using a SWI protocol. All images were collected and analyzed by applying a computer-aided fractal image analysis, which applies the fractal dimension as a measure of geometrical complexity of intratumoral SWI patterns. The results were subsequently statistically correlated to the histopathological tumor grade. RESULTS The mean value of the fractal dimension of the intratumoral SWI patterns was 2.086 ± 0.413. We found a trend of higher fractal dimension values in groups of higher histologic grade. The values ranged from a mean value of 1.682 ± 0.278 for grade II gliomas to 2.247 ± 0.358 for grade IV gliomas (p = 0.013); there was an overall statistically significant difference between histopathological groups. CONCLUSION The present study confirms that SWI at 7 T is a useful method for detecting intratumoral vascular architecture of brain gliomas and that SWI pattern quantification by means of fractal dimension offers a potential objective morphometric image biomarker of tumor grade.
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Affiliation(s)
- Antonio Di Ieva
- Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna, Vienna, Austria.
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