Intravoxel Incoherent Motion Diffusion-Weighted Imaging and 3D-ASL to Assess the Value of Ki-67 Labeling Index and Grade in Glioma.

Objective: To determine the proportion of intravoxel incoherent motion diffusion-weighted images (IVIM-DWI) and three-dimensional arterial circulation markers (3D-ASL) in Ki-67 labeling index (Ki-67 LI) and glioma grading.

Methods: According to the classification of diseases of the central nervous system dealt with by WHO in 2007, patients with stage II glioma were classified as low ( = 20) and patients with stages III-IV were divided into higher levels ( = 22). Prior to surgery, brain MRI, IVIM-DWI, and 3D-ASL were performed in all patients, and the actual water molecular diffusion coefficient (), microcirculation coefficient (∗), blood flow fraction (), and cerebral blood flow (CBF) were measured. A rank sum (Mann-Whitney test) was used to compare the four upper and lower level Ki-67 LI measurements. Spearman's method is used to identify the relationship between 4 groups of quantification and Ki-67 LI. Reciprocal grafting (ROC) curves were used to measure the diagnosis of four groups of glioma grading defects.

Results: There were significant differences in , ∗, , and CBF between the solid region of the tumor and the normal white matter contralateral to it ( < 0.05). The significant differences of , ∗, , and CBF were shown between patients with low-grade glioma and high-grade glioma ( < 0.05). Ki-67 LI was found to have negative correlation with ( = 00.693, < 0.001) and ( = 00.539, < 0.001), but similarly correlated with CBF ( = 0.665, < 0.001) in patients with glioma. Recipient efficacy for predicting advanced and secondary glioma from , , ∗, CBF, and Ki-67 LI raises AUCs of 0.819, 0.747, 0.719, 0.836, and 0.907, respectively.

Conclusion: IVIM-DWI has good application value for preoperative grading of glioma.