The Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the Differentiation of Pseudoprogression and Recurrence of Intracranial Gliomas

Abstract

Objective. The objective of this study was to determine the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing postoperative changes in intracranial gliomas. Method. A total of fifty-one patients who had new enhanced lesions after surgical resection followed by standard radiotherapy and chemotherapy were collected retrospectively from October 2014 to June 2021. The patients were divided into a pseudoprogression group (15 cases) and a recurrence group (36 cases) according to the pathological results of the second operation or a follow-up of more than six months. The follow-up data of all patients were complete, and DCE-MRI was performed. The images were processed to obtain the quantitative parameters Ktrans, Ve, and Kep and the semiquantitative parameter iAUC, which were analysed with relevant statistical software. Results. First, the difference in Ktrans and iAUC values between the two groups was statistically significant ( $P$  < 0.05), and the difference in Ve and Kep values was not statistically significant ( $P$  > 0.05). Second, by comparing the area under the curve, threshold, sensitivity and specificity of Ktrans, and iAUC, it was found that the iAUC threshold value was slightly higher than that of Ktrans, and the specificity of Ktrans was equal to that of iAUC, while the area under the curve and sensitivity of Ktrans were higher than those of iAUC. Third, Ktrans and iAUC had high accuracy in diagnosing recurrence and pseudoprogression, and Ktrans had higher accuracy than iAUC. Conclusion. In this study, DCE-MRI has a certain diagnostic value in the early differentiation of recurrence and pseudoprogression, offering a new method for the diagnosis and assessment of gliomas after surgery.