Histogram analysis of intravoxel incoherent motion and dynamic contrast-enhanced MRI with the two-compartment exchange model in glioma

Background: Since different grades of gliomas have different treatment programs, prognosis, and survival rates, it's important to differentiate them effectively. Intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) with the two-compartment exchange model (2CXM) have showed great potential for identifying the brain tumors. Materials and Methods: Thirty-nine patients with glioma underwent IVIM and DCE imaging at 3.0T. Quantitative parameters (mean, median, 10th, 25th, 75th and 90th percentiles) from IVIM (apparent diffusion coefficient (ADC), D, D*, f, and their product fD*) and DCE (v(p), v(e), PS, and F-p) were analyzed. The independent Student's t-test and Mann-Whitney U-tests were used to assess whether these parameters could distinguish low- from high-grade glioma. Receiver-operating characteristic (ROC) curve analysis and Delong test were performed to determine and compare the diagnostic efficiency of IVIM and DCE parameters in differentiating low- and high-grade gliomas, respectively. Results: Various histogram statistics of IVIM and DCE parameters could differentiate different grades of glioma. ve and vp generally yielded higher area under the curve (AUC) values than IVIM parameters, and the differences in AUC values of v(e)_mean and IVIM parameters had a statistical significance. Although DCE had higher AUC values than IVIM, they didn't reach statistical significance. Conclusions: ve was the best parameter in differential diagnosis of gliomas. IVIM had the similar diagnosis performance with DCE, and both IVIM and DCE-MRI parameters can be used for preoperative grading of gliomas.