Correlation of volume transfer coefficient Ktrans with histopathologic grades of gliomas

Purpose: To evaluate the roles of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and optimum tracer kinetic parameters in the noninvasive grading of the glial brain tumors with histopathological grades (IIV). Materials and Methods: Twenty-eight patients with histopathologically graded gliomas were imaged. Images with five flip angles were acquired before injection of gadolinium-DTPA and were processed to calculate the T1 value of each region of interest (ROI). All the DCE-MRI data acquired during the injection were processed based on the MRI signal and pharmacokinetic models to establish concentrationtime curves in the ROIs drawn within the tumors, contralateral normal areas, and area of the individual artery input functions (iAIF) of each patient. A nonlinear least-square-fitting method was used to obtain tracer kinetic parameters. KruskalWallis H-test and MannWhitney U-test were applied to these parameters in different histopathological grade groups for statistical differences (P < 0.05). Results: Volume transfer coefficient (Ktrans) and extravascular extracellular space volume fraction (Ve) calculated using iAIFs can be used not only to distinguish the low (ie, I and II) from the high (ie, III and IV) grade gliomas (P(?Ktrans) < 0.001 and PVe < 0.001), but also grade II from III (P(?Ktrans) = 0.016 and PVe = 0.033). Conclusion: Ktrans is the most sensitive and specific parameter in noninvasive grading, distinguishing the high (III and IV) from the low (I and II) grade and high grade III from low grade II gliomas. J. Magn. Reson. Imaging 2012;36:355363. (c) 2012 Wiley Periodicals, Inc.