Identification of CNS5 glioblastoma in lower-grade gliomas of the WHO CNS4R based on mean apparent propagator-magnetic resonance imaging
Objective To explore the value and significance of mean apparent propagator-magnetic resonance imaging(MAP-MRI)in identifying glioblastoma(GBM)classified by WHO CNS5 in 2021 from lower-grade gliomas classified by WHO CNS4R in 2016.Methods A total of 28 adult patients with WHO grade Ⅱ orⅢ diffuse gliomatosis cerebri classified by WHO CNS4R who were diagnosed and treated at Fujian Medical University Union Hospital from January 2019 to December 2022 were selected for the study.All patients underwent preoperative structural magnetic resonance imaging and diffusion magnetic resonance imaging.For diffusion magnetic resonance imaging,MAP-MRI and diffusion tensor imaging(DTI)were performed separately,and mean values of the mean square displacement(MSD),q-space inverse variance(QIV),return to the axis probability(RTAP),return to the origin probability(RTOP),return to the plane probability(RTPP),and mean diffusivity(MD)of the tumor solid area were extracted.Postoperative pathology and genetic testing were performed and then the patients were reclassified into the GBM group(n=6)and the non-GBM group(n=22)according to WHO CNS5 classification.Mann Whitney U-test was used to compare the differences in the values of MSD,QIV,RTAP,RTOP,RTPP,and MD between the two groups,and the receiver operating characteristic curve(ROC)was further plotted to evaluate its diagnostic efficacy in GBM.Results There were statistically significant differences in the values of QIV,RTAP,and MD in the solid tumor area between the two groups(P<0.05),with the most significant difference being between QIV and RTAP.The area under the curve(AUC)of receiver operator characteristic curve(ROC)was 0.78,with a specificity of 54.50%and a sensitivity of 100.00%.Conclusion MAP-MRI can differentiate CNS5 glioblastoma from lower-grade gliomas of WHO CNS4R to a certain extent,with QIV and RTAP having the best diagnostic efficacy.
Magnetic resonance imagingMean apparent propagator-magnetic resonanceGlioblastomaDiagnosis
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