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AJNR - American Journal of Neuroradiology

Published ahead of print on January 9, 2008
doi: 10.3174/ajnr.A0903

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American Journal of Neuroradiology 29:688-693, April 2008
© 2008 American Society of Neuroradiology

BRAIN

Perfusion Imaging of Brain Tumors Using Arterial Spin-Labeling: Correlation with Histopathologic Vascular Density

T. Noguchi^a, T. Yoshiura^a, A. Hiwatashi^a, O. Togao^a, K. Yamashita^a, E. Nagao^a, T. Shono^b, M. Mizoguchi^b, S. Nagata^b, T. Sasaki^b, S.O. Suzuki^c, T. Iwaki^c, K. Kobayashi^d, F. Mihara^a and H. Honda^a

^a Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
^b Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
^c Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
^d Radiological Center, Kyushu University Hospital, Fukuoka, Japan

Please address correspondence to Tomoyuki Noguchi, MD, Department of Clinical Radiology, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka PRF, Japan 812-8582; e-mail: tnogucci{at}radiol.med.kyushu-u.ac.jp

BACKGROUND AND PURPOSE: We investigated the relationship between tumor blood-flow measurement based on perfusion imaging by arterial spin-labeling (ASL-PI) and histopathologic findings in brain tumors.

MATERIALS AND METHODS: We used ASL-PI to examine 35 patients with brain tumors, including 11 gliomas, 9 meningiomas, 9 schwannomas, 1 diffuse large B-cell lymphoma, 4 hemangioblastomas, and 1 metastatic brain tumor. As an index of tumor perfusion, the relative signal intensity (SI) of each tumor (%Signal intensity) was determined as a percentage of the maximal SI within the tumor per averaged SI within normal cerebral gray matter on ASL-PI. Relative vascular attenuation (%Vessel) was determined as the total microvessel area per the entire tissue area on CD-34–immunostained histopathologic specimens. MIB1 indices of gliomas were also calculated. The differences in %Signal intensity among different histopathologic types and between high- and low-grade gliomas were compared. In addition, the correlations between %Signal intensity and %Vessel or MIB1 index were evaluated in gliomas.

RESULTS: Statistically significant differences in %Signal intensity were observed between hemangioblastomas versus gliomas (P < .005), meningiomas (P < .05), and schwannomas (P < .005). Among gliomas, %Signal intensity was significantly higher for high-grade than for low-grade tumors (P < .05). Correlation analyses revealed significant positive correlations between %Signal intensity and %Vessel in 35 patients, including all 6 histopathologic types (rs = 0.782, P < .00005) and in gliomas (rs = 0.773, P < .05). In addition, in gliomas, %Signal intensity and MIB1 index were significantly positively correlated (rs = 0.700, P < .05).

CONCLUSION: ASL-PI may predict histopathologic vascular densities of brain tumors and may be useful in distinguishing between high- and low-grade gliomas and in differentiating hemangioblastomas from other brain tumors.