Comparative analysis of the diffusion kurtosis imaging and diffusion tensor imaging in grading gliomas, predicting tumour cell proliferation and IDH-1 gene mutation status

J Neurooncol. 2019 Jan;141(1):195-203. doi: 10.1007/s11060-018-03025-7. Epub 2018 Nov 9.


Introduction: Few studies have applied diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) for the comprehensive assessment of gliomas [tumour grade, isocitrate dehydrogenase-1 (IDH-1) mutation status and tumour proliferation rate (Ki-67)]. This study describes the efficacy of DKI and DTI to comprehensively evaluate gliomas, compares their results.

Methods: Fifty-two patients (18 females; median age, 47.5 years) with pathologically proved gliomas were prospectively included. All cases underwent DKI examination. DKI (mean kurtosis: MK, axial kurtosis: Ka, radial kurtosis: Kr) and DTI (mean diffusivity: MD, fractional anisotropy: FA) maps of each metric was derived. Three ROIs were manually drawn.

Results: MK, Ka, Kr and FA were significantly higher in HGGs than in LGGs, whereas MD was significantly lower in HGGs than in LGGs (P < 0.01). ROC analysis demonstrated that MK (specificity: 100% sensitivity: 79%) and Ka (specificity: 96% sensitivity: 82%) had the same and highest (AUC: 0.93) diagnostic value. Moreover, MK, Ka, and Kr were significantly higher in grade III than II gliomas (P ≦ 0.01). Further, DKI and DTI can significantly identify IDH-1 mutation status (P ≦ 0.03). Ka (sensitivity: 74%, specificity: 75%, AUC: 0.72) showed the highest diagnostic value. In addition, DKI metrics and MD showed significant correlations with Ki-67 (P ≦ 0.01) and Ka had the highest correlation coefficient (rs = 0.72).

Conclusions: Compared with DTI, DKI has great advantages for the comprehensive assessment of gliomas. Ka might serve as a promising imaging index in predicting glioma grading, tumour cell proliferation rate and IDH-1 gene mutation status.

Keywords: Diffusion; Glioma; Isocitrate dehydrogenase; Ki-67 label index; Magnetic resonance imaging.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology*
  • Cell Proliferation
  • Diffusion Magnetic Resonance Imaging*
  • Diffusion Tensor Imaging*
  • Female
  • Glioma / diagnostic imaging*
  • Glioma / genetics
  • Glioma / pathology*
  • Humans
  • Isocitrate Dehydrogenase / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Grading
  • Prospective Studies
  • Sensitivity and Specificity
  • Young Adult


  • Isocitrate Dehydrogenase
  • IDH1 protein, human