Variations of ITSS-Morphology and their Relationship to Location and Tumor Volume in Patients with Glioblastoma

J Neuroimaging. 2015 Nov-Dec;25(6):1015-22. doi: 10.1111/jon.12228. Epub 2015 Feb 20.

Abstract

Background: Susceptibility weighted imaging and assessment of intratumoral susceptibility signal (ITSS) morphology is used to identify high-grade glioma (HGG) in patients with suspected brain neoplasm.

Purpose: The aim of this study was to outline variations in ITSS-morphology and their relationship to location as well as volume of the lesion in patients with glioblastoma (GB).

Materials and methods: Contrast-enhanced SWI (CE-SWI) images of 40 patients with histologically confirmed GB were analyzed retrospectively with particular attention to ITSS-morphology dividing all lesions into two groups. Considering the location of the lesion within brain parenchyma, lesions with and without involvement of the subventricular zone (SVZ+/SVZ-) were discerned. Additionally, the contrast-enhancing tumor volume was evaluated. Statistical analysis was based on a classification analysis resulting in a classification rule (tree) as well as Mann-Whitney-U test.

Results: The distribution of ITSS-scores showed differences between the SVZ+ and SVZ- groups. While SVZ-GB showed only fine-linear or dot-like ITSS, in SVZ+ GB the ITSS-morphology changed with the tumor volume, that is, in larger tumors dense and conglomerated ITSS were the predominant finding.

Conclusion: Our findings indicate that ITSS-morphology is not a random phenomenon. Location of GB, as well as tumor volume, appear to be factors contributing to ITSS morphology.

Keywords: Susceptibility weighted imaging; glioblastoma; intratumoral susceptibility; magnetic resonance imaging; signals.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Female
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / pathology
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tumor Burden