Grading of adults primitive glial neoplasms using arterial spin-labeled perfusion MR imaging

• Published in: Journal of neuroradiology Vol. 38; no. 4; pp. 207 - 213
• Main Authors: Canale, S, Rodrigo, S, Tourdias, T, Mellerio, C, Perrin, M, Souillard, R, Oppenheim, C, Meder, J F
• Format: Journal Article
• Language: French
• Published: France 01.10.2011
• Subjects: Adult; Aged; Brain Neoplasms - blood supply; Brain Neoplasms - pathology; Cerebrovascular Circulation; Female; Glioma - blood supply; Glioma - pathology; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Neoplasm Grading; Spin Labels
• ISSN: 0150-9861
• DOI: 10.1016/j.neurad.2010.12.003

We investigated the relationship between tumor blood-flow measurement based on perfusion-imaging by arterial spin-labeling (ASL) and histopathologic findings in adults' primitive glial tumours. Thus, 40 primitive brain tumors (8 low-grade and 32 high-grade gliomas according to the Sainte-Anne classification) were imaged using pulsed (n=19) or continuous (n=21) ASL. Relative cerebral blood flow (rCBF=tumoral blood flow/normal cerebral blood flow) between high- and low-grade gliomas were compared. Using pulsed ASL, differences in mean rCBF were observed in high- and low-grade gliomas although no significant (respectively 1.95 and 1.5). Using continuous ASL, mean rCBF were significantly higher for high-grade than for low-grade gliomas (P<0.05). High-grade gliomas could be discriminated using a CBF threshold of 1.18, with a sensitivity of 88%, specificity of 60%, predictive positive value of 88%, and predictive negative value of 60%. ASL-based perfusion provides a quantitative, non-invasive alternative to dynamic susceptibility contrast perfusion MR methods for evaluating CBF. ASL is a suitable method for gliomas initial staging and could be useful to identify intermediate tumoral evolution.