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Analysis of the mismatched manifestation between rCBF and rCBV maps in cerebral astrocytomas

  • Chun-hong Hu
    Correspondence
    Corresponding author. Imaging Center, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou City, Jiangsu Province, 215006, People's Republic of China. Tel.: +86 512 67780422.
    Affiliations
    Imaging Center, The First Affiliated Hospital of Soochow University, No.188, Shizi Street, Suzhou City, Jiangsu Province 215006, People's Republic of China
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  • Xiang-ming Fang
    Affiliations
    Imaging Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299, Qingyang Road, Wuxi City, Jiangsu Province 214023, People's Republic of China
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  • Xiao-yun Hu
    Affiliations
    Imaging Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299, Qingyang Road, Wuxi City, Jiangsu Province 214023, People's Republic of China
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  • Lei Cui
    Affiliations
    Imaging Center, The First Affiliated Hospital of Soochow University, No.188, Shizi Street, Suzhou City, Jiangsu Province 215006, People's Republic of China
    Search for articles by this author

      Abstract

      Objective

      To explore the mismatched manifestation between regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) of astrocytomas.

      Methods

      Both conventional and perfusion CT were performed on 29 patients with pathologically confirmed astrocytomas (15 cases in Grades I–II, 14 cases in Grades III–IV). Time-density curves were plotted, cerebral blood flow and volume maps were generated, and the values between rCBF and rCBV in the same region of interest (ROI) were compared.

      Results

      Twelve low-grade astrocytomas showed low or medium values of both rCBF (46.95±22.92 ml ⋅ 100 g−1 ⋅ mm−1) and rCBV (5.74±3.61 ml ⋅ 100 g−1); 12 high-grade astrocytomas showed high values of both rCBF (95.44±42.58 ml ⋅ 100 g−1 ⋅ min−1) and rCBV (9.24±5.32 ml ⋅ 100g−1). These cases exhibited agreement between the values of rCBF and rCBV. However, the remaining five astrocytomas were mismatched, showing reduced rCBF value and increased rCBV value in the same ROI. The discrepancy may mislead to an inaccuracy of perfusion CT in grading gliomas.

      Conclusions

      The mismatched manifestation between rCBF and rCBV occasionally exists in some areas of astrocytomas. Hence, attention should be paid to assessments in preoperative grading of astrocytomas and in monitoring therapeutic effects.

      Keywords

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      References

        • Smirniotopoulos JG
        The new WHO classification of brain tumors.
        Neuroimaging Clin N Am. 1999; 9: 595-613
        • Folkman J
        The role of angiogenesis in tumor growth.
        Semin Cancer Biol. 1992; 3: 65-71
        • Knopp EA
        • Cha S
        • Johnson G
        • et al.
        Glial neoplasms: dynamic contrast-enhanced T2*-weighted MR imaging.
        Radiology. 1999; 211: 791-798
        • Zagzag D
        • Friedlander DR
        • Dosik J
        • et al.
        Tenascin-C expression by angiogenic vessels in human astrocytomas and by human brain endothelial cells in vitro.
        Cancer Res. 1996; 56: 182-189
        • Brem S
        The role of vascular proliferation in the growth of brain tumors.
        Clin Neurosurg. 1976; 23: 440-453
        • Leon SP
        • Folkerth RD
        • Black PM
        Microvessel density is a prognostic indicator for patients with astroglial brain tumors.
        Cancer. 1996; 77: 362-372
        • Schiffer D
        • Chio A
        • Giordana MT
        • Leone M
        • Soffietti R
        Prognostic value of histologic factors in adult cerebral astrocytoma.
        Cancer. 1988; 61: 1386-1393
        • Aksoy FG
        • Lev MH
        Dynamic contrast-enhanced brain perfusion imaging: technique and clinical applications.
        Semin Ultrasound CT MR. 2000; 21: 462-477
        • Eastwood JD
        • Lev MH
        • Azhari T
        • et al.
        CT perfusion scanning with deconvolution analysis: pilot study in patients with acute middle cerebral artery stroke.
        Radiology. 2002; 222: 227-236
        • Kcenig M
        • Kraus M
        • Theek C
        • Klotz E
        • Gehlen W
        • Heuser L
        Quantitative assessment of the ischemic brain by means of perfusion-related parameters derived from perfusion CT.
        Stroke. 2001; 32: 431-437
        • Law M
        • Yang S
        • Babb JS
        • et al.
        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: 746-755
        • Ricci PE
        • Dungan DH
        Imaging of law-and intermediate-grade gliomas.
        Semin Radiat Oncol. 2001; 11: 103-112
        • Ellika SK
        • Jain R
        • Patel SC
        • et al.
        Role of perfusion CT in glioma grading and comparison with conventional MR imaging features.
        AJNR Am J Neuroradiol. 2007; 28: 1981-1987
        • Shin JH
        • Lee HK
        • Kwun BD
        • et al.
        Using relative blood flow and volume to evaluate the histopathologic grade of cerebral gliomas: preliminary results.
        AJR Am J Roentgenol. 2002; 179: 783-789
        • Edelman RR
        • Mattle HP
        • Atkinson DJ
        • et al.
        Cerebral blood flow: assessment with dynamic contrast-enhanced T2low asterisk-weighted MR imaging at 1.5 T.
        Radiology. 1990; 1761: 211-220
        • Hu CH
        • Wu QD
        • Hu XY
        • et al.
        Hemodynamic studies on brain CT perfusion imaging with varied injection rates.
        Clin Imaging. 2007; 31: 151-154
        • Sugahara T
        • Korogi Y
        • Kochi M
        • et al.
        Correlation of MR imaging determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas.
        AJR Am J Roentgenol. 1998; 171: 1479-1486
        • Jackson A
        • Kassner A
        • Annesley-Williams D
        • Reid H
        • Zhu XP
        • Li KL
        Abnormalities in the recirculation phase of contrast agent bolus passage in cerebral gliomas: comparison with relative blood volume and tumor grade.
        AJNR Am J Neuroradiol. 2002; 23: 7-14
        • Covarrubias DJ
        • Rosen BR
        • Lev MH
        Dynamic magnetic resonance perfusion imaging of brain tumors.
        Oncologist. 2004; 9: 528-537
        • Vajkoczy P
        • Schilling L
        • Ullrich A
        • Schmiedek P
        • Menger MD
        Characterization of angiogenesis and microcirculation of high-grade glioma: an intravital multifluorescence microscopie approach in the athymic nude mouse.
        J Cereb Blood Flow Metab. 1998; 18: 510-520
        • Miles KA
        • Griffiths MR
        Perfusion CT: a worthwhile enhancement?.
        Br J Radiol. 2003; 76: 220-231
        • Marmarou A
        • Takagi H
        • Shulman K
        Biomechanics of brain edema and effects on local cerebral blood flow.
        Adv Neurol. 1980; 28: 345-358
        • Steen RG
        Edema and tumor perfusion: characterization by quantitative 1H MR imaging.
        AJR Am J Roentgenol. 1992; 158: 259-264
        • Leenstra S
        • Troost D
        • Hulsebos TJ
        • Bosch DA
        Genetic versus histological grading in stereotactic biopsies.
        Stereotact Funct Neurosurg. 1994; 63: 56-62