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• Clinical Article •
The application of MR oxygen extraction fraction imaging in astrocytoma grading
SU Chang-liang  ZHANG Jia-xuan  ZHANG Shun  JIANG Jing-jing  JIANG Ri-feng  LIU Cheng-xia  ZHANG Ju  LIN Hui  ZHAO Ling-yun  ZHU Wen-zhen 

DOI:10.12015/issn.1674-8034.2016.09.001.


[Abstract] Objective: To explore the feasibility of quantitative measuring glioma oxygen extraction fraction (OEF) with OEF-imaging based on asymmetric spin-echo and to evaluate the diagnostic performance of OEF-related quantitative index in differentiating low- and high-grade gliomas.Materials and Methods: Thirty-two patients who were diagnosed with glioma via histopathology were recruited in the study, among which 16 cases were astrocytoma (grade Ⅱ), 5 cases of anaplastic astrocytoma and 11 cases of glioblastoma. The informed consent forms were obtained before the patients received MR scanning and the protocol employs axial T1WI、T2WI、T2FLAIR、SE-DWI、T1WI+C and ASE-OEF. The OEF of solid part of tumor and contralateral white matter was manually measured by. The statistic analysis was based on independent-sample t-test and one-way ANOVA, to identify the manifestation and diagnostic performance in low- and high-grade gliomas, the Pearson correlation analysis was applied to analyze the correlation between OEF and Ki-67 labeling index (Ki-67 LI).Results: In enhancement scanning, nonenhancement showed in ten of 16 low-grade gliomas, while only one patient showed nonenhancement, the difference of enhancement in low- and high-grade glioma was significant (P=0.002). The OEF in high-grade glioma was significantly higher than that in low-grade glioma (17.00±2.47 VS 20.46±2.98, P<0.01), the intra-class correlation coefficient was 0.89 indicating a good consistency in measurement results. The difference of Ki-67 LI in gliomas was significant (48±54.01, 5.8±8.76, P=0.01) and the Ki-67 LI was mildly correlated with OEF (r=0.406, P<0.05). The AUC of qualitative index depending on enhancement or nonenhancement in tumor solid part was 0.781 with 93.8% sensitivity and 62.5% specificity, while the AUC of OEF in differentiating low-and high-grade gliomas was 0.852 at a best threshold value of 19.55 with 81.3% sensitivity and 87.5% specificity.Conclusions: The ASE-MRI based on EPI can be applied in non-invasive measurement of glioma OEF. The quantitative parameter OEF is a excellent biomarker in differentiating high- and low-grade gliomas with good diagnstic performance and partly reflects the tumor proliferations. The potential application value of OEF in the diagnosis and management of glioma is worthwhile.
[Keywords] Oxygen extraction fraction imaging；Magnetic resonance imaging；Glioma；Neoplasm grading

SU Chang-liang Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

ZHANG Jia-xuan Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

ZHANG Shun Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

JIANG Jing-jing Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

JIANG Ri-feng Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

LIU Cheng-xia Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

ZHANG Ju Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

LIN Hui GE (China) Medical Group Wuhan Office, Wuhan 430022, China

ZHAO Ling-yun* Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

ZHU Wen-zhen Department of Radiology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

*Correspondence to: Zhao LY, E-mail: yummyqq@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  National "Twelfth Five-Year" Program of Science & Technology Support No. 2011BAI081310 National Natural Science Foundation of China No. 8157021103, 81171308
Received  2016-05-28
Accepted  2016-08-23
DOI: 10.12015/issn.1674-8034.2016.09.001
DOI:10.12015/issn.1674-8034.2016.09.001.

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