ArticleNeuroradiology2021
Perfusion imaging with arterial spin labeling (ASL)-MRI predicts malignant progression in low‑grade (WHO grade II) gliomas.
Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Multidisciplinary recommendations for routine follow-up of isocitrate dehydrogenase‑mutant glioma in 2026: Adapting clinical practice to the molecular era.Neuro-oncology practice · 2026Review
- Effective atomic number and electron density from dual-energy CT for differentiating malignant gliomas: Validation using the World Health Organization 2021 brain tumor classification.The neuroradiology journal · 2026Observational
- Usefulness of amide proton transfer images in the diagnosis of malignant glioma comparison of APT images and 11C-methionine-positron emission tomography.The neuroradiology journal · 2026Review
- Reconsidering gadolinium in long-term glioma follow-up: is contrast always and unquestionably necessary?European radiology · 2025Article
- The Differentiation between Progressive Disease and Treatment-Induced Effects with Perfusion-Weighted Arterial Spin-Labeling in High-Grade Gliomas.AJNR. American journal of neuroradiology · 2024Article
- Arterial spin labelling MRI for brain tumour surveillance: do we really need cerebral blood flow maps?European radiology · 2023Article
- A Review on the Use of Imaging Biomarkers in Oncology Clinical Trials: Quality Assurance Strategies for Technical Validation.Tomography (Ann Arbor, Mich.) · 2023Review
- Advanced MR Techniques for Preoperative Glioma Characterization: Part 1.Journal of magnetic resonance imaging : JMRI · 2023Review
- Predicting Survival in Patients with Brain Tumors: Current State-of-the-Art of AI Methods Applied to MRI.Diagnostics (Basel, Switzerland) · 2022Review
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7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePredicting malignant progression of grade II gliomas would allow for earlier initiation of treatment. The hypothesis for this single-centre, case-control study was that the perfusion signal on ASL-MRI predicts such malignant progression in the following 12 months.
methodsConsecutive patients with the following criteria were included: ≥ 18 years, grade II glioma (biopsied or resected) and an ASL-MRI 6-12 months prior to malignant progression (cases) or stable disease (controls). Malignant progression was defined either radiologically (new T1w-contrast enhancement) or histologically (neurosurgical tissue sampling). Three controls were matched with each case. Some patients served as their own control by using earlier imaging. The ASL-MRIs were reviewed by two neuroradiologists and classified as positive (hyper-intense or iso-intense compared to cortical grey matter) or negative (hypo-intense). In patients with epilepsy, a neurologist reviewed clinicoradiological data to exclude peri-ictal pseudoprogression. The statistical analysis included diagnostic test properties, a Cohen's Kappa interrater reliability coefficient and stratification for previous radiotherapy.
resultsEleven cases (median age = 48, IQR = 43-50 years) and 33 controls (43, 27-50 years) were included. Malignant progression appeared at 37 months (median, IQR = 17-44) after first surgery. Thirty ASL-MRIs were assessed as negative and 14 as positive. None of the MRIs showed signs of peri-ictal pseudoprogression. ASL significantly predicted subsequent malignant progression (sensitivity = 73%; specificity = 82%; OR = 12; 95%-CI = 2.4-59.1; p = 0.002). The interrater reliability coefficient was 0.65. In stratified analysis, ASL-MRI predicted malignant progression both in patients with previous radiotherapy and in those without (Mantel-Haenszel test, p = 0.003).
conclusionPerfusion imaging with ASL-MRI can predict malignant progression within 12 months in patients with grade II glioma.
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