Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles

• DOI: 10.1007/s00330-024-10611-z
• Publication Date: 2024-01-29T02:03:36Z
• Authors: Albert Pons-Escoda; Alonso Garcia-Ruiz; Pablo Naval-Baudin; Ignacio Martinez-...; Josep Castell; Angels Camins; Noemi Vidal; Jordi Bruna; Monica Cos; Raquel Perez-Lopez; Laura Oleaga; Esther Warnert; Marion Smits; Carles Majos
• Keywords: Neuroradiology; Cerebral blood volume

Abstract Objective Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. This research aims to provide a comprehensive understanding of each tumor’s DSC-PWI signatures, evaluate the discriminative capacity cerebral blood volume (CBV) percentage signal recovery (PSR) percentile values, explore synergy CBV PSR combination for pre-surgical differentiation. Methods Patients diagnosed with grade 2 3 IDH-mutant 1p19q-codeleted were retrospectively retrieved (2010–2022). 3D segmentations tumor conducted, voxel-level extracted compute mean, minimum, maximum, values. Statistical comparisons performed using Mann-Whitney U test area under receiver operating characteristic curve (AUC-ROC). Lastly, five most variables combined classification internal cross-validation. Results The study enrolled 52 patients (mean age 45-year-old, 28 men): 24 oligodendrogliomas. Oligodendrogliomas exhibited higher lower than across all metrics (e.g., mean = 2.05 1.55, 0.68 0.81 respectively). highest AUC-ROCs smallest p values originated from percentiles PSRp70 AUC-ROC 0.84 value 0.0005, CBVp75 0.8 0.0006). maximum yielded results. Combining best (PSRp65, CBVp70, PSRp60, CBVp75, PSRp40) achieved 0.87 Conclusions exhibit astrocytomas, traits that are emphasized when considering rather or extreme results promising outcomes. Clinical relevance statement histogram-derived enhances presurgical oligodendrogliomas, suggesting incorporating these into clinical practice could be beneficial. Key Points • unsupervised selection astrocytomas. Cerebral broader perspective on vasculature yield this preoperative classification.