TY - JOUR T1 - Perfusion MRI grading diffuse gliomas: Impact of permeability parameters on molecular biomarkers and survival JO - Neurocirugía (English edition) T2 - AU - Hilario,Amaya AU - Hernandez-Lain,Aurelio AU - Sepulveda,Juan Manuel AU - Lagares,Alfonso AU - Perez-Nuñez,Angel AU - Ramos,Ana SN - 11301473 M3 - 10.1016/j.neucir.2018.06.004 DO - 10.1016/j.neucir.2018.06.004 UR - https://revistaneurocirugia.com/es-perfusion-mri-grading-diffuse-gliomas-articulo-S1130147318300678 AB - Background and purposeOur objectives were: (1) compare dynamic susceptibility-weighted (DSC) and dynamic contrast-enhanced (DCE) permeability parameters, (2) evaluate diagnostic accuracy of DSC and DCE discriminating high- and low-grade tumors, (3) analyze relationship of permeability parameters with overall (OS) and progression-free survival (PFS) and (4) assess differences in high-grade tumors classified according to molecular biomarkers. Materials and methods49 patients with histologically proved diffuse gliomas underwent DSC and DCE imaging. Parametric maps of cerebral blood volume (CBV), CBV-leakage corrected, volume transfer coefficient (Ktrans), fractional volume of the extravascular extracellular space (EES) (Ve), fractional blood plasma volume (Vp) and rate constant between EES and blood plasma (Kep) were calculated. High-grade gliomas were also classified according to isocitrate dehydrogenase (IDH), alpha-thalassemia/mental retardation syndrome X-linked (ATRX) and O6-methylguanine-dna-methyltransferase promoter methylation (MGMT) status. ResultsThere is correlation between parameters leakage, Ktrans and Vp. ROC curve analysis showed significance in both Ktrans and Ve for glioma grading. Threshold value of 0.075 for Ve generated the best combination of sensitivity (80%) and specificity (75%) in tumor gradation. Leakage was the only permeability parameter related to OS (P=0.006) and PFS (0.012); with prolonged survival for leakage values lower than 1.2. IDH-mutated high-grade tumors showed lower leakage and Ktrans values. High-grade tumors with loss of ATRX presented lower leakage and Vp values. ConclusionsBoth DSC and DCE permeability parameters serve as non-invasive method for glioma grading. Leakage was the unique permeability parameter related to survival and the best discriminating high-grade gliomas classified according to IDH and ATRX status. ER -