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(Radiology. 1999;211:791-798.)
© RSNA, 1999

Neuroradiology

Glial Neoplasms: Dynamic Contrast-enhanced T2*-weighted MR Imaging1

Edmond A. Knopp, MD, Soonmee Cha, MD, Glyn Johnson, PhD, Avi Mazumdar, MD, John G. Golfinos, MD, David Zagzag, MD, PhD, Douglas C. Miller, MD, PhD, Patrick J. Kelly, MD and Irvin I. Kricheff, MD

1 From the Departments of Radiology (E.A.K., S.C., G.J., A.M., I.I.K.), Neurosurgery (E.A.K., J.G.G., P.J.K.), and Pathology (D.Z., D.C.M.) and the Kaplan Comprehensive Cancer Center (E.A.K., D.Z., D.C.M., P.J.K.), New York University Medical Center, 560 First Ave, New York, NY 10016. From the 1997 RSNA scientific assembly. Received April 21, 1998; revision requested July 2; revision received August 6; accepted November 6. Address reprint requests to E.A.K.

PURPOSE: To evaluate the role of T2*-weighted echo-planar perfusion imaging by using a first-pass gadopentetate dimeglumine technique to determine the association of magnetic resonance (MR) imaging–derived cerebral blood volume (CBV) maps with histopathologic grading of astrocytomas and to improve the accuracy of targeting of stereotactic biopsy.

MATERIALS AND METHODS: MR imaging was performed in 29 patients by using a first-pass gadopentetate dimeglumine T2*-weighted echo-planar perfusion sequence followed by conventional imaging. The perfusion data were processed to obtain a color map of relative regional CBV. This information formed the basis for targeting the stereotactic biopsy. Relative CBV values were computed with a nondiffusible tracer model. The relative CBV of lesions was expressed as a percentage of the relative CBV of normal white matter. The maximum relative CBV of each lesion was correlated with the histopathologic grading of astrocytomas obtained from samples from stereotactic biopsy or volumetric resection.

RESULTS: The maximum relative CBV in high-grade astrocytomas (n = 26) varied from 1.73 to 13.7, with a mean of 5.07 ± 2.79 (± SD), and in the low-grade cohort (n = 3) varied from 0.92 to 2.19, with a mean of 1.44 ± 0.68. This difference in relative CBV was statistically significant (P < .001; Student t test).

CONCLUSION: Echo-planar perfusion imaging is useful in the preoperative assessment of tumor grade and in providing diagnostic information not available with conventional MR imaging. The areas of perfusion abnormality are invaluable in the precise targeting of the stereotactic biopsy.

Index terms: Astrocytoma, 10.363, 10.3634 • Brain neoplasms, diagnosis, 10.363, 10.3634 • Brain neoplasms, MR, 10.121412, 10.121415, 10.121416, 10.12143, 10.12144 • Brain, perfusion, 10.363, 10.3634 • Magnetic resonance (MR), perfusion study, 10.12149 • Stereotaxis, 10.1267




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Am. J. Roentgenol., July 1, 2000; 175(1): 207 - 219.
[Full Text] [PDF]

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S. Cha, E. A. Knopp, G. Johnson, A. Litt, J. Glass, M. L. Gruber, S. Lu, and D. Zagzag
Dynamic Contrast-enhanced T2*-weighted MR Imaging of Recurrent Malignant Gliomas Treated with Thalidomide and Carboplatin
AJNR Am. J. Neuroradiol., May 1, 2000; 21(5): 881 - 890.
[Abstract] [Full Text]

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J. C. Wong, J. M. Provenzale, and J. R. Petrella
Perfusion MR Imaging of Brain Neoplasms
Am.