Comparison of Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging and Arterial Spin Labeling MR Imaging in Gliomas

<jats:p>Gliomas grading is important for treatment plan; we aimed to investigate the application of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in gliomas grading, by comparing with the three-dimensional pseudocontinuous arterial spin labeling (3D pCASL). 24 patients (13 high grade gliomas and 11 low grade gliomas) underwent IVIM DWI and 3D pCASL imaging before operation; maps of fast diffusion coefficient (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:msup><mml:mrow><mml:mi>D</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">∗</mml:mi></mml:mrow></mml:msup></mml:mrow></mml:math>), slow diffusion coefficient (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>D</mml:mi></mml:mrow></mml:math>), fractional perfusion-related volume (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:mi>f</mml:mi></mml:mrow></mml:math>), and apparent diffusion coefficient (ADC) as well as cerebral blood flow (CBF) were calculated and then coregistered to generate the corresponding parameter values. We found CBF and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:msup><mml:mrow><mml:mi>D</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">∗</mml:mi></mml:mrow></mml:msup></mml:mrow></mml:math>were higher in the high grade gliomas, whereas ADC,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mrow><mml:mi>D</mml:mi></mml:mrow></mml:math>, and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mrow><mml:mi>f</mml:mi></mml:mrow></mml:math>were lower (all<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>). In differentiating the high from low grade gliomas, the maximum areas under the curves (AUC) of<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mrow><mml:msup><mml:mrow><mml:mi>D</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">∗</mml:mi></mml:mrow></mml:msup></mml:mrow></mml:math>, CBF, and ADC were 0.857, 0.85, and 0.902, respectively. CBF was negatively correlated with<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mrow><mml:mi>f</mml:mi></mml:mrow></mml:math>in tumor (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M10"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0.619</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M11"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:math>). ADC was positively correlated with<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M12"><mml:mrow><mml:mi>D</mml:mi></mml:mrow></mml:math>in both tumor and white matter (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M13"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn>0.887</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M14"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.000</mml:mn></mml:math>and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M15"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn>0.824</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M16"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.000</mml:mn></mml:math>, resp.). There was no correlation between CBF and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M17"><mml:mrow><mml:msup><mml:mrow><mml:mi>D</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">∗</mml:mi></mml:mrow></mml:msup></mml:mrow></mml:math>in both tumor and white matter (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M18"><mml:mi>P</mml:mi><mml:mo>></mml:mo><mml:mn>0.05</mml:mn></mml:math>). IVIM DWI showed more efficiency than 3D pCASL but less validity than conventional DWI in differentiating the high from low grade gliomas.</jats:p>