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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:760-769, April 2005
© 2005 American Society of Neuroradiology

BRAIN

Relationship of MR-Derived Lactate, Mobile Lipids, and Relative Blood Volume for Gliomas in Vivo

Xiaojuan Li^a,b, Daniel B. Vigneron^a,b, Soonmee Cha^b, Edward E. Graves^d, Forrest Crawford^a,b, Susan M. Chang^c and Sarah J. Nelson^a,b

^a Center of Functional and Molecular Imaging, University of California, San Francisco
^b Department of Radiology, University of California, San Francisco
^c Department of Neurological Surgery, University of California, San Francisco
^d Department of Radiation Oncology, Stanford University, Palo Alto, CA

Address reprint requests to Xiaojuan Li, PhD, 185 Berry St, Ste 350, Department of Radiology, University of California at San Francisco, San Francisco, CA 94107

BACKGROUND AND PURPOSE: Gliomas are heterogeneous tumors with increased microvasculature, hypoxia, and necrosis. The purpose of this study was to examine the distribution and relationship of the MR-derived relative cerebral blood volume (rCBV), lactate (Lac), and mobile lipids (Lip), which have been proposed as markers for these phenomena of gliomas in vivo.

METHODS: Twenty-three patients with newly diagnosed gliomas were examined before surgical biopsy and/or resection (seven grade II, five grade III, and 11 grade IV), and 27 patients were studied after surgery but before radiation treatment and/or chemotherapy (11 grade II, two grade III, and 14 grade IV gliomas). Lac and Lip were estimated from Lac-edited three-dimensional MR spectroscopic images. Dynamic susceptibility–contrast MR imaging was applied to obtain perfusion-weighted images and rCBV maps.

RESULTS: Before surgical biopsy/resection, one low-grade and 12 of 16 high-grade gliomas had significantly elevated Lac. No low-grade and 10 of 16 high-grade gliomas had significantly elevated Lip. In presurgical high-grade gliomas, volumes of elevated Lip and macronecrosis were significantly correlated. rCBV was significantly increased in regions with elevated Lac. After we excluded macronecrosis, the rCBV for regions with elevated Lip but no Lac was significantly higher than rCBV in regions with elevated Lac but no Lip. After surgical biopsy/resection, more low-grade patients showed significantly elevated Lac and Lip than before.

CONCLUSION: The in vivo distribution of rCBV, Lac, and Lip, as evaluated with three-dimensional MR spectroscopic imaging, may help in the diagnosis and selection of the most appropriate therapy for patients with gliomas.

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