Assessment of Diagnostic Accuracy of Perfusion MR Imaging in Primary and Metastatic Solitary Malignant Brain Tumors

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2005 Oct 13

PMID 16219821

Citations 45

Authors

Nail Bulakbasi

Murat Kocaoglu

Anar Farzaliyev

Cem Tayfun

Taner Ucoz

Ibrahim Somuncu

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to estimate the diagnostic accuracy of relative cerebral blood volume (rCBV) measurement in preoperative grading and differentiation of solitary intra-axial malignant brain tumors.

Methods: Thirty-six low-grade glial tumors (LGGTs), 22 high-grade glial tumors (HGGTs), and 17 metastases (METs) were prospectively evaluated by MR imaging and standard dynamic susceptibility contrast-enhanced gradient echo, echoplanar imaging during first pass of a bolus injection of contrast material. Normalized rCBV values from tumoral (rCBV(T)) and peritumoral (rCBV(P)) areas were calculated by standard software and statistically tested independently.

Results: The mean differences of rCBV(T) and rCBV(P) values between LGGT (2.30 +/- 1.12 and 1.18 +/- 0.24) and HGGT (5.42 +/- 1.52 and 2.17 +/- 0.82) (P < .001); HGGTs and METs (3.21 +/- 0.98 and 0.97 +/- 0.09) (P < .001); and LGGTs and METs (P < .05 and P < .001, respectively) were significant. No clear cutoff value was present. A clear rCBV(T) cutoff value of 2.6 was detected for differentiation of low- (1.75 +/- 0.38; LGA) versus high-grade (4.78 +/- 0.99; HGA) astrocytomas when nonastrocytic glial tumors were excluded. The rCBV(T) values were linearly correlated with degree of malignancy (r = 0.869; P < .001). Cutoff rCBV(P) values of 1.1 and 1.2 were quite effective in differentiation of METs from LGGTs and HGGTs, respectively. The overall efficacy of rCBV was higher in grading than in differentiation.

Conclusion: The diagnostic accuracy of rCBV measurement is higher in grading of glial brain tumors than in differentiation of HGGTs from solitary intra-axial METs. The astrocytic and nonastrocytic glial tumors have to be evaluated separately for precise grading.

Citing Articles

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Machine learning decision tree models for multiclass classification of common malignant brain tumors using perfusion and spectroscopy MRI data.

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Khorasani A, Tavakoli M, Saboori M, Jalilian M Eur J Radiol Open. 2021; 8:100378.

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References

Oh J, Henry R, Pirzkall A, Lu Y, Li X, Catalaa I . Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume. J Magn Reson Imaging. 2004; 19(5):546-54. DOI: 10.1002/jmri.20039. View

Lev M, Ozsunar Y, Henson J, Rasheed A, Barest G, Harsh 4th G . Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol. 2004; 25(2):214-21. PMC: 7974605. View

Cha S, Knopp E, Johnson G, Wetzel S, Litt A, Zagzag D . Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology. 2002; 223(1):11-29. DOI: 10.1148/radiol.2231010594. View

Roberts H, Roberts T, Brasch R, Dillon W . Quantitative measurement of microvascular permeability in human brain tumors achieved using dynamic contrast-enhanced MR imaging: correlation with histologic grade. AJNR Am J Neuroradiol. 2000; 21(5):891-9. PMC: 7976746. View

Wetzel S, Cha S, Johnson G, Lee P, Law M, Kasow D . Relative cerebral blood volume measurements in intracranial mass lesions: interobserver and intraobserver reproducibility study. Radiology. 2002; 224(3):797-803. DOI: 10.1148/radiol.2243011014. View

Rosen B, Belliveau J, Vevea J, Brady T . Perfusion imaging with NMR contrast agents. Magn Reson Med. 1990; 14(2):249-65. DOI: 10.1002/mrm.1910140211. View

Leach M, Brindle K, Evelhoch J, Griffiths J, Horsman M, Jackson A . Assessment of antiangiogenic and antivascular therapeutics using MRI: recommendations for appropriate methodology for clinical trials. Br J Radiol. 2004; 76 Spec No 1:S87-91. DOI: 10.1259/bjr/15917261. View

Law M, Yang S, Babb J, Knopp E, Golfinos J, Zagzag D . Comparison of cerebral blood volume and vascular permeability from dynamic susceptibility contrast-enhanced perfusion MR imaging with glioma grade. AJNR Am J Neuroradiol. 2004; 25(5):746-55. PMC: 7974484. View

Tropres I, Lamalle L, Peoch M, Farion R, Usson Y, Decorps M . In vivo assessment of tumoral angiogenesis. Magn Reson Med. 2004; 51(3):533-41. DOI: 10.1002/mrm.20017. View

10.

Bitzer M, Klose U, Nagele T, Friese S, Kuntz R, Fetter M . Echo planar perfusion imaging with high spatial and temporal resolution: methodology and clinical aspects. Eur Radiol. 1999; 9(2):221-9. DOI: 10.1007/s003300050659. View

11.

Cha S, Tihan T, Crawford F, Fischbein N, Chang S, Bollen A . Differentiation of low-grade oligodendrogliomas from low-grade astrocytomas by using quantitative blood-volume measurements derived from dynamic susceptibility contrast-enhanced MR imaging. AJNR Am J Neuroradiol. 2005; 26(2):266-73. PMC: 7974081. View

12.

Kremer S, Grand S, Berger F, Hoffmann D, Pasquier B, Remy C . Dynamic contrast-enhanced MRI: differentiating melanoma and renal carcinoma metastases from high-grade astrocytomas and other metastases. Neuroradiology. 2003; 45(1):44-9. DOI: 10.1007/s00234-002-0886-8. View

13.

Rampling R, James A, Papanastassiou V . The present and future management of malignant brain tumours: surgery, radiotherapy, chemotherapy. J Neurol Neurosurg Psychiatry. 2004; 75 Suppl 2:ii24-30. PMC: 1765659. DOI: 10.1136/jnnp.2004.040535. View

14.

Daldrup H, Shames D, Wendland M, Okuhata Y, Link T, Rosenau W . Correlation of dynamic contrast-enhanced magnetic resonance imaging with histologic tumor grade: comparison of macromolecular and small-molecular contrast media. Pediatr Radiol. 1998; 28(2):67-78. DOI: 10.1007/s002470050296. View

15.

Weisskoff R, Rosen B . Noninvasive determination of regional cerebral blood flow in rats using dynamic imaging with Gd(DTPA). Magn Reson Med. 1992; 25(1):211-2. DOI: 10.1002/mrm.1910250122. View

16.

Su M, Muhler A, Lao X, Nalcioglu O . Tumor characterization with dynamic contrast-enhanced MRI using MR contrast agents of various molecular weights. Magn Reson Med. 1998; 39(2):259-69. DOI: 10.1002/mrm.1910390213. View

17.

Roberts H, Roberts T, Bollen A, Ley S, Brasch R, Dillon W . Correlation of microvascular permeability derived from dynamic contrast-enhanced MR imaging with histologic grade and tumor labeling index: a study in human brain tumors. Acad Radiol. 2001; 8(5):384-91. DOI: 10.1016/S1076-6332(03)80545-7. View

18.

Folkman J . Role of angiogenesis in tumor growth and metastasis. Semin Oncol. 2003; 29(6 Suppl 16):15-8. DOI: 10.1053/sonc.2002.37263. View

19.

Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T . Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol. 1998; 171(6):1479-86. DOI: 10.2214/ajr.171.6.9843274. View

20.

Ludemann L, Grieger W, Wurm R, Budzisch M, Hamm B, Zimmer C . Comparison of dynamic contrast-enhanced MRI with WHO tumor grading for gliomas. Eur Radiol. 2001; 11(7):1231-41. DOI: 10.1007/s003300000748. View