Comparison of the normalized cerebral blood volume (CBV) between different models and evaluation of the efficacy of gadolinium leakage in evaluating preoperative adult-type gliomas

Background: Dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) can be used to differentiate the glioma grade and characterize the high-perfusion cores of gliomas. However, the arterial input function (AIF) and gamma-variate fitting (GVF) can both derive perfusion metrics [e.g., the relative cerebral blood volume (rCBV)]. The study aimed to compare the consistency of the normalized rCBV (nrCBV) between AIF and GVF in adult-type gliomas with different grades and isocitrate dehydrogenase (IDH) statuses, and then investigated the efficiency of percentage of signal recovery (PSR) and gadolinium (Gd) leakage effects in evaluating adult-type gliomas. Methods: A total of 60 patients with preoperative adult-type gliomas [IDH-mutant (IDHM): 37 vs. IDH wild-type (IDHW): 23] were retrospectively imaged via DSC-PWI, which was processed to obtain the nrCBV via AIF (AIF-nrCBV) and GVF (GVF-nrCBV). IDHM includes adult-type gliomas with grade 2 [19] and grade 3 [18]. IDHW includes 23 adult-type gliomas with grade 4. The PSR was calculated from the raw time-signal intensity curve (TIC). T2* and T1 leakage effects derived from AIF were graded via a Likert scale (ranging from 0 to 3). The correlation and paired difference of nrCBV between AIF and GVF were analyzed by linear correlation analysis and Bland-Altman plots in adult-type gliomas with different grades and IDH statuses. Spearman correlation analysis was used to test the correlation between PSR and two leakage effects. The differences of PSR and both leakage effect in adult-type gliomas with different grades and IDH statuses (IDHMvs. IDHW) were evaluated by one-way analysis of variance and Fisher’s exact test. Results: AIF-nrCBV was correlated with GVF-nrCBV in adult-type gliomas with different grades and IDH statuses (r=0.56–0.90, all P