Primary application of mean apparent propagator-MRI diffusion model in the grading of diffuse glioma

Eur J Radiol. 2021 May:138:109622. doi: 10.1016/j.ejrad.2021.109622. Epub 2021 Mar 6.


Purpose: To evaluate the diagnostic -->performance of mean apparent propagator-magnetic resonance imaging (MAP-MRI) in distinguishing the grades of diffuse gliomas.

Method: Thirty-six patients with pathologically confirmed diffuse gliomas were enrolled in this study. MAP-MRI parameters were measured in the parenchymal area of the tumour: non-Gaussianity (NG), non-Gaussianity axial (NGAx), non-Gaussianity vertical (NGRad), Q-space inverse variance (QIV), return to the origin probability (RTOP), return to the axis probability (RTAP), return to the plane probability (RTPP), and mean square displacement (MSD). Differences in the parameters between any two grades were compared, the characteristics of the parameters for different diffuse glioma grades were analysed, and receiver operating characteristic (ROC) curves were plotted to analyse the diagnostic value of each parameter.

Results: Compared with grade III gliomas, grade II gliomas had lower NG, NGAx and NGRad values. NG, NGAx and NGRad had great area under the ROC curve (AUC) values (0.823, 0.835, and 0.838, P < 0.05). Compared with those of grade IV glioma, the NG, NGAx, NGRad, RTAP and RTOP values for grade II glioma were lower, the QIV values were higher (all P < 0.05). NG, NGAx, NGRad, RTAP, RTOP and QIV had great area under the ROC curve (AUC) values (0.923, 0.929, 0.923,0.793,0.822, and 0.769, P < 0.05).

Conclusions: Quantitative MAP-MRI parameters can distinguish grade II and III and grade II and IV gliomas before surgery but not grade III and IV gliomas. Thus, these parameters have clinical guiding value in the noninvasive preoperative evaluation of tumour pathological grading.

Keywords: Brain tumour; Diffuse glioma; Mean apparent diffusion magnetic resonance imaging; Non-Gaussian.

MeSH terms

  • Brain Neoplasms* / diagnostic imaging
  • Diffusion Magnetic Resonance Imaging
  • Glioma* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Grading
  • Sensitivity and Specificity