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Evaluation of in and out sequences to grade gliomas in adults

Purpose : The objective of our study was to evaluate the performance of the In Phase and Out of Phase (IP/OP) sequences in gliomas pre-operative radiological staging.

Materials and Methods : From April 2016 to June 2017, a prospective cross-sectional study including 69 patients with different grades of gliomas was conducted. All patients underwent pre-operative multi-parametric imaging including the IP/OP sequences. An intra-tumoral signal loss measurement was performed for each patient to detect and quantify the lipids presence within the tumor. The results were correlated to anatomo-pathology diagnosis used as gold-standard.

Results : The statistical analysis revealed highly significant differences of signal loss ratio (SLR) between the different grades (p= 0.0001) without machine interference on the staging. These differences were significant between grade II and grade III (p= 0.0001) and between grades III and IV (p= 0.0004). A SLR above 9 ‰ predicts grade III with 100% specificity and sensitivity, while a SLR above 20 ‰ predicts a grade IV with 73% specificity and 75 % sensitivity.

Conclusion : Our results suggest that the IP/OP sequence can be used in daily clinical practice as an additional tool for gliomas staging and would enable the early detection of an anaplastic switch. 336 ##$aTaille du fichier PDF : 1090 Ko

Keywords : magnetic resonance imaging, glioma classification, in and opposed phase imaging, chemical shift imaging, signal loss ratio.