Review Article

Clinical Applications of Contrast-Enhanced Perfusion MRI Techniques in Gliomas: Recent Advances and Current Challenges

Table 6

Discrimination of recurrent glioma from radiation necrosis.

Study (year) (ref)Group ()Average age (year)Imaging modality (method or model; parameter analysis)IndexesThreshold (Sp%, Sn%)Limitations

Barajas et al. (2009) [182]RN (17) 
rGB (40)
54DSC-MRI (alteration of and flip angle for leakage correction, ROI-based analysis)rCBV  
rPH  
rPSR
rPH = 1.38 (81.38%, 89.32%) 
rPSR = 87.3% (76.19%, 78.26%) 
rCBV = 1.75 (71.58%, 78.92%)
Impact of partial volume averaging effect on parameter evaluation

Hu et al. (2009) [183]rHGG (24) 
RN (16)
47DSC-MRI (baseline subtraction method for leakage correction; ROI-based analysis)rCBVrCBV = 0.71 (100%, 91.7%)Various tumor types; inconsistent radiation dose and different therapies

Bisdas et al. (2011) [184]rHGG (12) 
RN (6)
N/ADCE-MRI (TK model; ROI-based analysis)


IAUC
= 0.19 (83%, 100%) 
IAUC = 15.35 (71%, 71%) 
No significant difference of and between RN and rHGG
Small sample size; lack of histopathologic confirmation in some cases

Shin et al. (2014) [158]Recurrent glioma (19) 
RN (4)
55DCE-MRI (TK model; ROI-based analysis), DSC-MRI (preload for leakage corrected; ROI-based analysis)r
rIAUC  
rCBV
rCBV = 2.33 (70%, 72.2%) 
r = 2.1 (80%, 61.1%) 
rIAUC = 2.29 (70%, 66.6%)
Relative small sample size; ROI-based method was not comprehensive

Larsen et al. (2013) [185]Recurrent glioma (11) 
RN (3)
56DCE-MRI (deconvolution technique)CBVCBV = 2.0 ml/100 g (100%, 100%)Small sample size; sample bias in histological analysis; various tumor types

Masch et al. (2016) [186]Recurrent glioma (16) 
RN (8)
51DSC-MRI (preload for leakage correction; ROI-based analysis)rCBVNot provided; elevated rCBV in recurrent lesion compared with RNVarious tumor types; lack of histological confirmation in some cases