Non-invasive assessment of glioma microstructure using VERDICT MRI: correlation with histology.
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Authors
Priest, Andrew N
McLean, Mary A
Allinson, Kieren
Grist, James T
Dragos, Carmen
Gillard, Jonathan H
Watts, Colin
Price, Stephen J
Graves, Martin J
Gallagher, Ferdia A
Publication Date
2019-10Journal Title
Eur Radiol
ISSN
0938-7994
Publisher
Springer Science and Business Media LLC
Volume
29
Issue
10
Pages
5559-5566
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Zaccagna, F., Riemer, F., Priest, A. N., McLean, M. A., Allinson, K., Grist, J. T., Dragos, C., et al. (2019). Non-invasive assessment of glioma microstructure using VERDICT MRI: correlation with histology.. Eur Radiol, 29 (10), 5559-5566. https://doi.org/10.1007/s00330-019-6011-8
Abstract
PURPOSE: This prospective study evaluated the use of vascular, extracellular and restricted diffusion for cytometry in tumours (VERDICT) MRI to investigate the tissue microstructure in glioma. VERDICT-derived parameters were correlated with both histological features and tumour subtype and were also used to explore the peritumoural region. METHODS: Fourteen consecutive treatment-naïve patients (43.5 years ± 15.1 years, six males, eight females) with suspected glioma underwent diffusion-weighted imaging including VERDICT modelling. Tumour cell radius and intracellular and combined extracellular/vascular volumes were estimated using a framework based on linearisation and convex optimisation. An experienced neuroradiologist outlined the peritumoural oedema, enhancing tumour and necrosis on T2-weighted imaging and contrast-enhanced T1-weighted imaging. The same regions of interest were applied to the co-registered VERDICT maps to calculate the microstructure parameters. Pathology sections were analysed with semi-automated software to measure cellularity and cell size. RESULTS: VERDICT parameters were successfully calculated in all patients. The imaging-derived results showed a larger intracellular volume fraction in high-grade glioma compared to low-grade glioma (0.13 ± 0.07 vs. 0.08 ± 0.02, respectively; p = 0.05) and a trend towards a smaller extracellular/vascular volume fraction (0.88 ± 0.07 vs. 0.92 ± 0.04, respectively; p = 0.10). The conventional apparent diffusion coefficient was higher in low-grade gliomas compared to high-grade gliomas, but this difference was not statistically significant (1.22 ± 0.13 × 10-3 mm2/s vs. 0.98 ± 0.38 × 10-3 mm2/s, respectively; p = 0.18). CONCLUSION: This feasibility study demonstrated that VERDICT MRI can be used to explore the tissue microstructure of glioma using an abbreviated protocol. The VERDICT parameters of tissue structure correlated with those derived on histology. The method shows promise as a potential test for diagnostic stratification and treatment response monitoring in the future. KEY POINTS: • VERDICT MRI is an advanced diffusion technique which has been correlated with histopathological findings obtained at surgery from patients with glioma in this study. • The intracellular volume fraction measured with VERDICT was larger in high-grade tumours compared to that in low-grade tumours. • The results were complementary to measurements from conventional diffusion-weighted imaging, and the technique could be performed in a clinically feasible timescale.
Keywords
Brain neoplasms, Cancer, Diagnostic imaging, Diffusion magnetic resonance imaging, Glioma, Adult, Aged, Brain Neoplasms, Diffusion Magnetic Resonance Imaging, Feasibility Studies, Female, Glioma, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Neoplasm Grading, Prospective Studies, Reproducibility of Results, Young Adult
Sponsorship
This work has been funded by Cancer Research UK (CRUK; C19212/A16628) and the CRUK & Engineering and Physical Sciences Research Council (EPSRC) Cancer Imaging Centre in Cambridge and Manchester (C197/A16465).
Additional support has been provided by the CRUK Cambridge Centre, the National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre and Addenbrooke’s Charitable Trust.
Funder references
Cancer Research Uk (None)
Cancer Research Uk (None)
Identifiers
External DOI: https://doi.org/10.1007/s00330-019-6011-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288316
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