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Grading of CNS neoplasms using continuous arterial spin labeled perfusion MR imaging at 3 Tesla

✍ Scribed by Ronald L. Wolf; Jiongjiong Wang; Sumei Wang; Elias R. Melhem; Donald M. O'Rourke; Kevin D. Judy; John A. Detre


Publisher
John Wiley and Sons
Year
2005
Tongue
English
Weight
383 KB
Volume
22
Category
Article
ISSN
1053-1807

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✦ Synopsis


Abstract

Purpose

To differentiate glioma grade based on blood flow measured using continuous arterial spin labeled (CASL) perfusion MRI, implemented at 3 Tesla for improved signal‐to‐noise ratio (SNR) and spin labeling effect.

Materials and Methods

CASL perfusion images were obtained preoperatively in 26 patients with brain neoplasms (19 high‐grade gliomas (HGGs; WHO grades 3 and 4) and seven low‐grade gliomas (LGGs; WHO grades 1 and 2)). The mean and maximum tumor blood flow (TBF and TBF~max~) were calculated in the neoplasm, including surrounding infiltrating tumor vs. edema. Measures normalized to global CBF (nTBF and nTBF~max~) were also obtained.

Results

Normalized measures of TBF~max~ provided the best distinction between HGG and LGG groups (Wilcoxon rank sum test, P = 0.01). Seventeen of 19 HGGs showed nTBF~max~ > 1.0, and 15 of 19 showed nTBF~max~ > 1.3. Four of seven LGGs showed nTBF~max~ < 1.0, and six of seven showed nTBF~max~ < 1.3. Absolute TBF~max~ also differed significantly between the HGG and LGG groups (P = 0.04). TBF~max~ in 11 of 17 HGGs was >50 mL/100 g/min (mean ± SD = 94.9 ± 71.7 mL/100 g/min). All but one LGGs showed TBF~max~ ≤ 50 mL/100 g/min (mean ± SD = 42.8 ± 22.0 mL/100 g/min).

Conclusion

CASL perfusion MRI provides a quantitative, noninvasive alternative to dynamic susceptibility contrast perfusion MR methods for evaluating gliomas. J. Magn. Reson. Imaging 2005. © 2005 Wiley‐Liss, Inc.