Review Article

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

Table 3

Examples of perfusion MRI for identifying molecular characterization.

Study (year) (ref)Group ()Average age (year)Imaging modality (method or model; parameter analysis)IndexesResultsLimitations

Kickingereder et al. (2015) [60]Grades II and III: 
IDH (+) (59) 
IDH (−) (14)
49DSC-MRI (algorithm for leakage correction; histogram analysis)rCBVrCBV was significantly different between IDH mutation and wild-type tumorsOnly including grades II and III tumors

Lee et al. (2015) [61]HGG: 
IDH (+) (16) 
IDH (−) (36)
50DSC-MRI (algorithm for leakage correction; histogram analysis)nCBVSignificant difference of nCBV between IDH mutation and wildtype; higher heterogeneity in mutation tumor than the wild-typeNot including LGG. Not excluding influence of MGMT mutation

Tykocinski et al. (2012) [62]GBM: 
EGFRvIII (+) (30) 
EGFRvIII (−) (102)
61DSC-MRI (preload for leakage correction; ROI-based  analysis)rCBVStrong correlation between rCBV and EGFRvIII statusRelative small sample size of EGFRvIII-positive tumors

Gupta et al. (2015) [63]GBM: 
EGFR (+) (44) 
EGFR (−) (62) 
EGFRvIII (+) (18) 
EGFRvIII (−) (47)
66DSC-MRI (γ-variate function for leakage correction; ROI-based analysis)PSR  
rPH 
rCBV
Higher rCBV and lower PSR were associated with EGFR; higher rPH was related to EGFRvIII mutationPathologic sampling may not be consistent with ROI selection

Arevalo-Perez et al. (2015) [64]GBM: 
EGFRvIII (+) (24) 
EGFRvIII (−) (58)
66DCE-MRI (ETK model; histogram analysis)
Strong correlation between both parameters and EGFRvIII status; was better than for diagnosisNot eliminating influence of other molecular mutations

Jung et al. (2013) [65]GBM: 
MGMT (+) (16) 
MGMT (−) (9)
52DSC-MRI (γ-variate function for leakage correction; ROI-based analysis)nCBVnCBV was higher in MGMT-negative tumors than in MGMT-positive tumorsSmall sample size

Moon et al. (2012) [66]HGG: 
MGMT (+) (11) 
MGMT (−) (13)
51DSC-MRI (leakage effect uncorrected; ROI-based analysis) DTIrCBV  
ADC
No significant correlation between rCBV and MGMTSmall sample size; impact leakage effect of rCBV accuracy

Ahn et al. (2014) [67]GBM: 
MGMT (+) (16) 
MGMT (−) (27)
58DCE-MRI (TK model; ROI-based analysis); DTI


ADC
Only was correlated with MGMTSubjectivity of ROI-based method

Jenkinson et al. (2006) [68]Grades II and III: 
Codeletion (+) (19) 
Codeletion (−) (18)
44DSC-MRI (leakage effect uncorrected; ROI-based analysis)rCBVrCBV was associated with 1p/19q codeletion in oligodendrogliomaSubjectivity of ROI-based method; impact leakage effect of rCBV accuracy

Emblem et al. (2008) [42]Grades II and III: 
Codeletion (+) (11) 
Codeletion (−) (11)
52DSC-MRI (algorithm for leakage correction; histogram analysis)rCBVHistogram analysis of rCBV could differentiate 1p/19q genotype in astrocytic and oligodendroglial tumorsSmall sample size; only the peak height of histogram distribution was assessed