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Prognostic value of perfusion-weighted imaging in brain glioma: a prospective study

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Summary

Object. Biopsy targeting based on MR imaging alone may fail to identify malignant areas in brain gliomas. Considering the differences in relative Cerebral Blood Volume (rCBV) ratios reported among tumour grades, we evaluated whether perfusion-weighted MR imaging (PWI) could usefully implement the routine preoperative imaging by detecting those areas bearing a higher yield for malignancy to guide the stereotactic biopsy or the surgical removal.

Clinical material and methods. We studied a series of 55 consecutive patients with newly diagnosed brain glioma using both conventional MR imaging and PWI in the preoperative assessment. The pathological diagnosis was established by stereotactic biopsy in 29 cases and by craniotomy in 24 cases. We evaluated the patient survival to detect undergrading.

Discussion. Independent from contrast-enhancement, perfusion-weighted MR imaging improved the target selection in stereotactic biopsy guidance and the removal of malignant areas in tumours amenable to surgery. Particularly sensitive to the perfused part of the tumour as to small regional changes, rCBV maps allowed a better detection of malignant areas. The rCBV ratios correlated significantly to the tumour grade and the final outcome (p < 0.01).

Conclusions. We found PWI valuable in the preoperative assessment of brain gliomas, discriminating high from low-grade gliomas. PWI can easily be performed on widely available MR imaging systems as part of the routine imaging of gliomas.

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References

  • HJ Aronen IE Gazit DN Louis BR Buchbinder FS Pardo RM Weisskoff GR Harsh GR Cosgrove EF Halpern FH Hochberg (1994) ArticleTitleCerebral blood volume maps of gliomas: comparison with tumour grade and histologic findings. Radiology 191 41–51 Occurrence Handle1:STN:280:ByuC1c7otVc%3D Occurrence Handle8134596

    CAS  PubMed  Google Scholar 

  • HJ Aronen J Glass FS Pardo JW Belliveau ML Gruber BR Buchbinder IE Gazit RM Linggood AJ Fischman BR Rosen (1995) ArticleTitleEcho-planar MR cerebral blood volume mapping of gliomas: clinical utility. Acta Radiol 36 520–528 Occurrence Handle1:STN:280:ByqA28jjs1A%3D Occurrence Handle7640098

    CAS  PubMed  Google Scholar 

  • S Asari T Makabe S Katayama T Itoh S Tsuchida T Ohmoto (1994) ArticleTitleAssessment of the pathological grade of astrocytic gliomas using an MRI score. Neuroradiology 36 308–310 Occurrence Handle10.1007/BF00593267 Occurrence Handle1:STN:280:ByuA2cvktVY%3D Occurrence Handle8065577

    Article  CAS  PubMed  Google Scholar 

  • FG Barker Suffix2nd SM Chang SL Huhn RL Davis PH Gutin MW McDermott CB Wilson MD Prados (1997) ArticleTitleAge and the risk of anaplasia in magnetic resonance-nonenhancing supratentorial cerebral tumors. Cancer 80 936–941 Occurrence Handle10.1002/(SICI)1097-0142(19970901)80:5<936::AID-CNCR15>3.0.CO;2-X Occurrence Handle9307194

    Article  PubMed  Google Scholar 

  • A Batra RP Tripathi AK Singh (2004) ArticleTitlePerfusion magnetic resonance imaging and magnetic resonance spectroscopy of cerebral gliomas showing imperceptible contrast enhancement on conventional magnetic resonance imaging. Australasian Radiology 48 324–332 Occurrence Handle1:STN:280:DC%2BD2crltF2htg%3D%3D Occurrence Handle15344981

    CAS  PubMed  Google Scholar 

  • F Benard J Romsa R Hustinx (2003) ArticleTitleImaging gliomas with positron emission tomography and single-photon emission computed tomography. Semin Nucl Med 33 IssueID2 148–162 Occurrence Handle10.1053/snuc.2003.127304 Occurrence Handle12756647

    Article  PubMed  Google Scholar 

  • S Brem R Cotran J Folkman (1972) ArticleTitleTumor angiogenesis: a quantitative method for histologic grading. J Natl Cancer Inst 48 347–356 Occurrence Handle1:STN:280:CSyC38%2FkvVQ%3D Occurrence Handle4347034

    CAS  PubMed  Google Scholar 

  • R Bruening KK Kwong MJ Vevea (1996) ArticleTitleEcho-planar MR determination of relative cerebral blood volume in human brain tumors: T1 versus T2 weighting. AJNR 17 831–840 Occurrence Handle1:STN:280:BymA3Mngtl0%3D Occurrence Handle8733954

    CAS  PubMed  Google Scholar 

  • BL Dean BP Drayer CR Bird (1990) ArticleTitleGliomas Classification with MR imaging. Radiology 174 411–415 Occurrence Handle1:STN:280:By%2BC3MnjvVE%3D Occurrence Handle2153310

    CAS  PubMed  Google Scholar 

  • G Di Chiro RL De LaPaz RA Brooks L Sokoloff PL Kornblith BH Smith NJ Patronas CV Kufta RM Kessler GS Johnston RG Manning AP Wolf (1982) ArticleTitleGlucose utilization of cerebral gliomas measured by [18F] fluorodeoxyglucose and positron emission tomography. Neurology 32 1323–1329 Occurrence Handle1:STN:280:BiyD28zivVA%3D Occurrence Handle6983044

    CAS  PubMed  Google Scholar 

  • KN Fountas EZ Kapsalaki RL Vogel I Fezoulidis JS Robinson ED Gotsis (2004) ArticleTitleNoninvasive histologic grading of solid astrocytomas using proton magnetic resonance spectroscopy. Stereotact Funct Neurosurg 92 90–97

    Google Scholar 

  • LE Ginsberg GN Fuller M Hashmi NE Leeds DF Schomer (1998) ArticleTitleThe Significance of Lack of MR Contrast Enhancement of Supratentorial Brain Tumors in Adults: Histopathological Evaluation of a Series. Surg Neurol 49 436–440 Occurrence Handle1:STN:280:DyaK1c7pslSitg%3D%3D Occurrence Handle9537664

    CAS  PubMed  Google Scholar 

  • RG Henry DB Vigneron NJ Fischbein PE Grant MR Day SM Noworolski JM Star-Lack LL Wald WP Dillon SM Chang SJ Nelson (2000) ArticleTitleComparison of Relative Cerebral Blood Volume and Proton Spectroscopy in Patients with Treated Gliomas. AJNR 21 357–366 Occurrence Handle1:STN:280:DC%2BD3c7lvVGksw%3D%3D Occurrence Handle10696024

    CAS  PubMed  Google Scholar 

  • A Jackson A Kassner D Annesley-Williams H Reid X-P Zhu K-L Li (2002) ArticleTitleAbnormalities in the Recirculation Phase of Contrast Agent Bolus Passage in Cerebral Gliomas: comparison with Relative Blood Volume and Tumor Grade. AJNR 23 7–14 Occurrence Handle11827869

    PubMed  Google Scholar 

  • Kleihues P, Cavenee WK (eds) (2000) World Health Organisation classification of tumours: pathology and genetics of tumours of the nervous system. IARC Press, Lyon

  • EA Knopp S Cha G Johnson A Mazumdar JG Golfinos D Zagzag DC Miller PJ Kelly II Kricheff (1999) ArticleTitleGlial neoplasms: dynamic contrast-enhanced T2-weighted MR imaging. Radiology 211 791–798 Occurrence Handle1:STN:280:DyaK1M3otVyktg%3D%3D Occurrence Handle10352608

    CAS  PubMed  Google Scholar 

  • D Kondziolka LD Lunsford AJ Martinez (1993) ArticleTitleUnreliability of contemporary neurodiagnostic imaging in evaluating suspected adult supratentorial (low-grade) astrocytoma. J Neurosurg 79 533–536 Occurrence Handle1:STN:280:ByuD3MrjsFE%3D Occurrence Handle8410222

    CAS  PubMed  Google Scholar 

  • S Kremer S Grand C Remy F Esteve V Lefournier B Pasquier D Hoffmann AL Benabid JF Le Bas (2002) ArticleTitleCerebral blood volume mapping by MR imaging in the initial evaluation of brain tumors. J Neuroradiol 29 105–113 Occurrence Handle1:STN:280:DC%2BD38vosFantQ%3D%3D Occurrence Handle12297732

    CAS  PubMed  Google Scholar 

  • YE Kuznetzov Z Caramanos SB Antel MC Preul R Leblanc JG Villemure R Pokrupa A Olivier A Sadikot DL Arnold (2003) ArticleTitleProton magnetic resonance spectroscopic imaging can predict length of survival in patients with supratentorial gliomas. Neurosurgery 53 565–574

    Google Scholar 

  • M Law S Yang JS Babb EA Knopp JG Golfinos D Zagzag G Johnson (2004) ArticleTitleComparison of Cerebral Blood Volume and Vascular Permeability from Dynamic Susceptibility Contrast-Enhanced Perfusion MR Imaging with Glioma Grade. AJNR 25 746–755 Occurrence Handle15140713

    PubMed  Google Scholar 

  • M Law S Yang H Wang JS Babb G Johnson S Cha EA Knopp D Zagzag (2003) ArticleTitleGlioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24 IssueID10 1989–1998 Occurrence Handle14625221

    PubMed  Google Scholar 

  • V Lefournier M Peoc’h Y Usson JL Bosson S Grand B Pasquier JF Le Bas (2003) ArticleTitleMagnetic resonance cerebral blood volume maps. Comparison with histologic findings in different types of brain lesions. J Neuroradiol 30 3–9 Occurrence Handle1:STN:280:DC%2BD3s7htV2rug%3D%3D Occurrence Handle12624585

    CAS  PubMed  Google Scholar 

  • SP Leon RD Folkerth PM Black (1996) ArticleTitleMicrovessel density is a prognostic indicator for patients with astroglial brain tumors. Cancer 77 362–372 Occurrence Handle10.1002/(SICI)1097-0142(19960115)77:2<362::AID-CNCR20>3.0.CO;2-Z Occurrence Handle1:STN:280:BymB38zjslE%3D Occurrence Handle8625246

    Article  CAS  PubMed  Google Scholar 

  • MH Lev Y Ozsunar JW Henson AA Rasheed GD Barest Harsh GR Suffix4th MM Fitzek EA Chiocca JD Rabinov AN Csavoy BR Rosen FH Hochberg PW Schaefer RG Gonzalez (2004) ArticleTitleGlial 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. AJNR 25 214–221 Occurrence Handle14970020

    PubMed  Google Scholar 

  • L Ludemann W Grieger R Wurm M Budzisch B Hamm C Zimmer (2001) ArticleTitleComparison of dynamic contrast-enhanced MRI with WHO tumor grading for gliomas. Eur Radiol 11 1231–1241 Occurrence Handle1:STN:280:DC%2BD38%2FitlCrug%3D%3D Occurrence Handle11471617

    CAS  PubMed  Google Scholar 

  • M Maeda S Itoh H Kimura T Iwasaki N Hayashi K Yamamoto Y Ishii T Kubota (1993) ArticleTitleTumor vascularity in the brain: evaluation with dynamic susceptibility-contrast MR imaging. Radiology 189 233–238 Occurrence Handle1:STN:280:ByyA1czgs1U%3D Occurrence Handle8372199

    CAS  PubMed  Google Scholar 

  • ACM Maia SuffixJr SMF Malheiros AJ Da Rocha JN Stavale IF Guimaraes LRR Borges AJ Santos CJ Da Silva JGSP De Melo OP Lanzoni AA Gabbai FAP Ferraz (2004) ArticleTitleStereotactic biopsy guidance in adults with supratentorial nonenhancing gliomas: role of perfusion-weighted magnetic resonance imaging. J Neurosurg 101 970–976 Occurrence Handle15597757

    PubMed  Google Scholar 

  • C Majos J Alonso C Aguilera M Serrallonga J Perez-Martin JJ Acebes C Arus J Gili (2003) ArticleTitleProton magnetic resonance spectroscopy ((1)H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization. Eur Radiol 13 IssueID3 582–591 Occurrence Handle12594562

    PubMed  Google Scholar 

  • WH Martin D Delbeke JA Patton (1996) ArticleTitleDetection of malignancies with SPECT versus PET, with 2-[fluorine-18] fluoro-2-deoxy-D-glucose. Radiology 198 225–231 Occurrence Handle1:STN:280:BymC38zhslY%3D Occurrence Handle8539384

    CAS  PubMed  Google Scholar 

  • T Naëgele D Petersen U Klose (1993) ArticleTitleDynamic contrast enhancement of intracranial tumors with snapshot-FLASH MR imaging. AJNR 14 89–98 Occurrence Handle1:STN:280:ByyC2M7gvVE%3D

    CAS  Google Scholar 

  • R Nafe S Herminghaus U Pilatus E Hattingen G Marquardt W Scholte H Lanfermann F Zanella (2004) ArticleTitleMorphology of proliferating and non-proliferating tumor cell nuclei in glioblastomas correlates with preoperative data from proton-MR-spectroscopy. Neuropathology 24 172–182 Occurrence Handle10.1111/j.1440-1789.2004.00547.x Occurrence Handle15484695

    Article  PubMed  Google Scholar 

  • T Ogawa A Inugami J Hatazawa (1996) ArticleTitleClinical positron emission tomography for brain tumors: comparison of fluorodeoxyglucose F18 and L-methyl C-methionone. AJNR Am J Neuroradiol 17 345–353 Occurrence Handle1:STN:280:ByiD1M3lvFU%3D Occurrence Handle8938309

    CAS  PubMed  Google Scholar 

  • J Oh RG Henry A Pirzkall Y Lu X Li I Catalaa S Chang WP Dillon SJ Nelson (2004) ArticleTitleSurvival 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 19 546–554 Occurrence Handle10.1002/jmri.20039 Occurrence Handle15112303

    Article  PubMed  Google Scholar 

  • MV Padma S Said M Jacobs DR Hwang K Dunigan M Satter B Christian J Ruppert T Bernstein G Kraus JC Mantil (2003) ArticleTitlePrediction of pathology and survival by FDG PET in gliomas. J Neurooncol 64 IssueID3 227–237 Occurrence Handle10.1023/A:1025665820001 Occurrence Handle1:STN:280:DC%2BD3svotVWgsQ%3D%3D Occurrence Handle14558598

    Article  CAS  PubMed  Google Scholar 

  • J Perkio HJ Aronen A Kangasmaki Y Liu J Karonen S Savolainen L Ostergaard (2002) ArticleTitleEvaluation of four postprocessing methods for determination of cerebral blood volume and mean transit time by dynamic susceptibility contrast imaging. Magn Reson Med 47 973–981 Occurrence Handle11979577

    PubMed  Google Scholar 

  • M Plotkin J Eisenacher H Bruhn R Wurm R Michel F Stockhammer A Feussner O Dudeck P Wust R Felix H Amthauer (2004) ArticleTitle123I-IMT SPECT and 1H MR-spectroscopy at 3.0 T in the differential diagnosis of recurrent or residual gliomas: a comparative study. J Neurooncol 70 49–58 Occurrence Handle10.1023/B:NEON.0000040810.77270.68 Occurrence Handle15527107

    Article  PubMed  Google Scholar 

  • C Preul B Kühn EW Lang HM Mehdorn M Heller J Link (2003) ArticleTitleDifferentiation of cerebral tumors using multi-section echo planar MR perfusion imaging European. J Radiology 48 244–251

    Google Scholar 

  • JM Provenzale GR Wang T Brenner JR Petrella AG Sorensen (2002) ArticleTitleComparison of permeability in high-grade and low-grade brain tumors using dynamic susceptibility contrast MR imaging. AJR Am J Roentgenol 178 IssueID3 711–716 Occurrence Handle11856703

    PubMed  Google Scholar 

  • J Pruim AT Willemsen WM Molenaar (1995) ArticleTitleBrain tumors: L-[1-C-11] tyrosine PET for visualization and quantification of protein synthesis rate. Radiology 197 221–226 Occurrence Handle1:CAS:528:DyaK2MXptlaksL4%3D Occurrence Handle7568827

    CAS  PubMed  Google Scholar 

  • HC Roberts TP Roberts RC Brasch WP Dillon (2000) ArticleTitleQuantitative measurement of microvascular permeability in human brain tumors achieved using dynamic contrast-enhanced MR imaging: correlation with histologic grade. AJNR Am J Neuroradiol 21 891–899 Occurrence Handle1:STN:280:DC%2BD3c3ntlSrtQ%3D%3D Occurrence Handle10815665

    CAS  PubMed  Google Scholar 

  • BR Rosen JW Belliveau JM Vevea (1990) ArticleTitlePerfusion imaging with NMR contrast agents. Magn Reson Med 14 249–265 Occurrence Handle1:STN:280:By%2BB28risFc%3D Occurrence Handle2345506

    CAS  PubMed  Google Scholar 

  • M Sasaki Y Kuwabara T Yoshida M Nakagawa T Fukumura F Mihara T Morioka M Fukui K Masuda (1998) ArticleTitleA comparative study of thallium-201 SPECT, carbon-11 methionine PET and fluorine-18 fluorodeoxyglucose PET for the differentiation of astrocytic tumours. Eur J Nucl Med 25 IssueID9 1261–1269 Occurrence Handle10.1007/s002590050294 Occurrence Handle1:STN:280:DyaK1czptFOitA%3D%3D Occurrence Handle9724375

    Article  CAS  PubMed  Google Scholar 

  • JH Shin HK Lee BD Kwun JS Kim W Kang CG Choi DC Suh (2002) ArticleTitleUsing relative cerebral blood flow and volume to evaluate the histopathologic grade of cerebral gliomas: preliminary results. AJR 179 IssueID3 783–789 Occurrence Handle12185064

    PubMed  Google Scholar 

  • T Siegal R Rubinstein T Tzuk-Shina JM Gomori (1997) ArticleTitleUtility of relative cerebral blood volume mapping derived from perfusion magnetic resonance imaging in the routine follow up of brain tumors. J Neurosurg 86 22–27 Occurrence Handle1:STN:280:ByiC2c7ot1M%3D Occurrence Handle8988077

    CAS  PubMed  Google Scholar 

  • T Sugahara Y Korogi M Kochi I Ikushima T Hirai T Okuda Y Shigematsu L Liang Y Ge Y Ushio M Takahashi (1998) ArticleTitleCorrelation of MR Imaging-Determined Cerebral Blood Volume Maps with Histologic and Angiographic Determination of Vascularity of Gliomas. AJR 171 1479–1486 Occurrence Handle1:STN:280:DyaK1M%2FlslCjug%3D%3D Occurrence Handle9843274

    CAS  PubMed  Google Scholar 

  • M Tamura T Shibasaki A Zama H Kurihara S Horikoshi N Ono N Oriuchi T Hirano (1998) ArticleTitleAssessment of malignancy of glioma by positron emission tomography with 18F-fluorodeoxyglucose and single photon emission computed tomography with thallium-201 chloride. Neuroradiology 40 IssueID4 210–215 Occurrence Handle10.1007/s002340050569 Occurrence Handle1:STN:280:DyaK1c3lsFWntQ%3D%3D Occurrence Handle9592789

    Article  CAS  PubMed  Google Scholar 

  • G Tedeschi N Lundbom R Raman S Bonavita JH Duyn JR Alger G Di Chiro (1997) ArticleTitleIncreased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study. J Neurosurg 87 IssueID4 516–524 Occurrence Handle1:STN:280:ByiH283mtFE%3D Occurrence Handle9322842

    CAS  PubMed  Google Scholar 

  • M Watanabe R Tanaka N Takeda (1992) ArticleTitleMagnetic resonance imaging and histopathology of cerebral gliomas. Neuroradiology 34 463–469 Occurrence Handle1:STN:280:ByyD28znvFE%3D Occurrence Handle1436452

    CAS  PubMed  Google Scholar 

  • D Yang Y Korogi T Sugahara M Kitajima Y Shigematsu L Liang Y Ushio M Takahashi (2002) ArticleTitleCerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar perfusion and diffusion-weighted MRI. Neuroradiology 44 656–666 Occurrence Handle1:STN:280:DC%2BD38vivVOrtQ%3D%3D Occurrence Handle12185543

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium

    C. Chaskis, K. Van Rompaey & J. D’Haens

  2. Department of Neuroimaging, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium

    T. Stadnik

  3. Department of Neuropathology, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium

    A. Michotte

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  1. C. Chaskis
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  2. T. Stadnik
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Chaskis, C., Stadnik, T., Michotte, A. et al. Prognostic value of perfusion-weighted imaging in brain glioma: a prospective study. Acta Neurochir (Wien) 148, 277–285 (2006). https://doi.org/10.1007/s00701-005-0718-9

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