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• CLINICAL ARTICLE •
The diagnostic value of IVIM in glioma grading and its correlation with Ki-67 labeling index
CHANG Tianjing  SHEN Huicong  YU Meimei  GE Ying  ZHANG Yang  ZHANG Zhe  JI Nan 

Cite this article as: Chang TJ, Shen HC, Yu MM, et al. The diagnostic value of IVIM in glioma grading and its correlation with Ki-67 labeling index[J]. Chin J Magn Reson Imaging, 2021, 12(2): 19-23. DOI:10.12015/issn.1674-8034.2021.02.005.


[Abstract] Objective To investigate the value of introvoxel incoherent motion (IVIM) parameters in predicting preoperative grade of glioma and its correlation with Ki-67 labeling index. Materials andMethods Sixty-three patients (43 males and 20 females), aged from 16 to 74 (47±13) years, were retrospectively analyzed. They were divided into low-grade group (30 cases of WHO grade II) and high-grade group (33 cases of WHO grade III and IV). Ki-67 labeling index was obtained by immunohistochemistry. All patients underwent routine MRI scan and IVIM-DWI examination before operation. The IVIM parameters of the largest solid area and contralateral normal white matter area were measured, and the apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion related diffusion coefficient (D*) and perfusion fraction (f) were obtained. The measured value of solid area was divided by the value of contralateral normal brain parenchymal area. The corrected parameters were obtained: relative ADC (relative ADC, rADC), relative D (relative D, rD), relative D* (relative D*, rD*), relative f (relative f, rf). Rank sum test (Mann Whitney U test) was used to compare the differences of four quantitative parameters and Ki-67 between high and low-grade groups. Spearman method was used to analyze the correlation between the four quantitative parameters and Ki-67 LI. Receiver operator characteristic curve (ROC) was used to evaluate the diagnostic efficacy of four quantitative parameters in the grading of glioma.Results The rADC, rD and rf values in low-grade glioma group were higher than those in high-grade glioma group (P＜0.05). There was no significant difference in rD* between the two groups (P=0.139). The average Ki-67 labeling index in high-grade glioma group was significantly higher than that in low-grade glioma group (P＜0.01).The area under the ROC curve of rADC, rD and rf values were 0.912, 0.911 and 0.714, the thresholds were 1.280, 1.295 and 1.171, the sensitivities were 93.3%, 90.0%, 86.7%, and the specificities were 75.8%, 78.8% and 48.5%. There was a strong negative correlation between rADC, rD and Ki-67 labeling index, a low correlation between rD* and Ki-67 labeling index, but no significant correlation between rf and Ki-67 labeling index.Conclusions IVIM can noninvasively evaluate the grade of glioma, among which rADC has the highest diagnostic efficiency. Ki-67 labeling index was significantly different between high-grade and low-grade gliomas, and had a strong negative correlation with rADC and rD, which could provide help for the clinical diagnosis, formulation of treatment plan and prognosis judgment of glioma.
[Keywords] magnetic resonance imaging；glioma；introvoxel incoherent motion imaging；Ki-67 labeling index；tumor grading

CHANG Tianjing1   SHEN Huicong1*   YU Meimei1   GE Ying1   ZHANG Yang2   ZHANG Zhe2   JI Nan2  

1 Department of Radiology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100070, China

2 Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100070, China

Shen HC, E-mail: shenhuicong@126.com

Conflicts of interest   None.

ACKNOWLEDGENTS This work was part of Beijing Municipal Science and Technology Project (No.Z181100001718196).
Received  2020-09-22
Accepted  2020-11-15
DOI: 10.12015/issn.1674-8034.2021.02.005
Cite this article as: Chang TJ, Shen HC, Yu MM, et al. The diagnostic value of IVIM in glioma grading and its correlation with Ki-67 labeling index[J]. Chin J Magn Reson Imaging, 2021, 12(2): 19-23. DOI:10.12015/issn.1674-8034.2021.02.005.

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