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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:455-461, March 2007
© 2007 American Society of Neuroradiology

BRAIN

Stereotactic Comparison among Cerebral Blood Volume, Methionine Uptake, and Histopathology in Brain Glioma

N. Sadeghi^a, I. Salmon^b, C. Decaestecker^e, M. Levivier^c, T. Metens^a, D. Wikler^c,d, V. Denolin^a, S. Rorive^b, N. Massager^c, D. Baleriaux^a and S. Goldman^d

^a Department of Radiology, Hôpital Erasme, Brussels, Belgium
^b Department of Pathology, Hôpital Erasme, Brussels, Belgium
^c Department of Neurosurgery, Hôpital Erasme, Brussels, Belgium
^d PET/Biomedical Cyclotron Unit, Hôpital Erasme, Brussels, Belgium
^e Laboratory of Toxicology, Université Libre de Bruxelles, Boulevard du Triomphe, Brussels, Belgium

Address correspondence to Niloufar Sadeghi, MD, Department of Radiology, Hôpital Erasme, 808, Route de Lennik, 1070 Brussels, Belgium; e-mail: nsadeghi{at}ulb.ac.be

BACKGROUND AND PURPOSE: Vascularity, metabolism, and histologic grade are related in gliomas but the exact determinants of these relationships are not fully defined. We used image coregistration and stereotactic biopsies to regionally compare cerebral blood volume (CBV) and ¹¹C-methionine (MET) uptake measurements in brain gliomas and to assess their relationship by histopathologic examination.

MATERIALS AND METHODS: Fourteen patients with brain gliomas underwent MR imaging, including dynamic susceptibility contrast-enhanced MR and positron-emission tomography (PET) using MET acquired in identical stereotactic conditions before biopsy. MR-based CBV maps were calculated and both CBV maps and PET images were coregistered to anatomic images. Sixty-five biopsy samples were obtained on trajectories targeted toward high MET uptake area. The following histopathologic features were semiquantified in each sample: mitotic activity, endothelial proliferation, cellular pleomorphism, and tumor necrosis. CBV and MET uptake values were measured in the biopsy area and normalized to contralateral white matter. CBV ratios were compared with MET uptake ratios, and both measurements were compared with histologic features of each sample.

RESULTS: CBV ratios ranged from 0.08 to 10.24 (median = 1.73), and MET uptake ratios ranged from 0.30 to 4.91 (median = 1.67). There was a positive correlation between CBV ratios and MET uptake ratios (r = 0.65, P < .001). Both CBV and MET uptake ratios were found to be significantly related to endothelial proliferation and mitotic activity (P < .01).

CONCLUSION: Within glial tumors, there is a local relationship between CBV and MET uptake measurements. Both provide indices of focal malignant activity.

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