Histogram analysis of T2*-based pharmacokinetic imaging in cerebral glioma grading

Background and objective To investigate the feasibility of histogram analysis of the T2*-based permeability parameter volume transfer constant (K^trans) for glioma grading and to explore the diagnostic performance of the histogram analysis of K^trans and blood plasma volume (v_p). Methods We recruited 31 and 11 patients with high- and low-grade gliomas, respectively. The histogram parameters of K^trans and v_p, derived from the first-pass pharmacokinetic modeling based on the T2* dynamic susceptibility-weighted contrast-enhanced perfusion-weighted magnetic resonance imaging (T2* DSC-PW-MRI) from the entire tumor volume, were evaluated for differentiating glioma grades. Results Histogram parameters of K^trans and v_p showed significant differences between high- and low-grade gliomas and exhibited significant correlations with tumor grades. The mean K^trans derived from the T2* DSC-PW-MRI had the highest sensitivity and specificity for differentiating high-grade gliomas from low-grade gliomas compared with other histogram parameters of K^trans and v_p. Conclusions Histogram analysis of T2*-based pharmacokinetic imaging is useful for cerebral glioma grading. The histogram parameters of the entire tumor K^trans measurement can provide increased accuracy with additional information regarding microvascular permeability changes for identifying high-grade brain tumors.