• Julio Arevalo-Perez, Kyung K Peck, Robert J Young, Andrei I Holodny, Sasan Karimi, and John K Lyo.
• Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
• J Neuroimaging. 2015 Sep 1; 25 (5): 792-8.

PurposeAccurate glioma grading is crucial for treatment planning and predicting prognosis. We performed a quantitative volumetric analysis to assess the diagnostic accuracy of histogram analysis of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) T1-weighted perfusion imaging in the preoperative evaluation of gliomas.MethodsSixty-three consecutive patients with pathologically confirmed gliomas who underwent baseline DWI and DCE-MRI were enrolled. The patients were classified by histopathology according to tumor grade: 20 low-grade gliomas (grade II) and 43 high-grade gliomas (grades III and IV). Volumes-of-interest were calculated and transferred to DCE perfusion and apparent diffusion coefficient (ADC) maps. Histogram analysis was performed to determine mean and maximum values for Vp and Ktrans , and mean and minimum values for ADC. Comparisons between high-grade and low-grade gliomas, and between grades II, III, and IV, were performed. A Mann-Whitney U test at a significance level of corrected P ≤ .01 was used to assess differences.ResultsAll perfusion parameters could differentiate between high-grade and low-grade gliomas (P < .001) and between grades II and IV, grades II and III, and grades III and IV. Significant differences in minimum ADC were also found (P < .01). Mean ADC only differed significantly between high and low grades and grades II and IV (P < .01). There were no differences between grades II and III (P = .1) and grades III and IV (P = .71).ConclusionWhen derived from whole-tumor histogram analysis, DCE-MRI perfusion parameters performed better than ADC in noninvasively discriminating low- from high-grade gliomas.Copyright © 2015 by the American Society of Neuroimaging.

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