Differentiation of Low-Grade Oligodendrogliomas from Low-Grade Astrocytomas by Using Quantitative Blood-Volume Measurements Derived from Dynamic Susceptibility Contrast-Enhanced MR Imaging
Soonmee Chaa,b,
Tarik Tihanc,
Forrest Crawforda,
Nancy J. Fischbeina,
Susan Changb,
Andrew Bollenc,
Sarah J. Nelsona,
Michael Pradosb,
Mitchel S. Bergerb and
William P. Dillona,b
a Department of Radiology, University of California San Francisco Medical Center
b Department of Neurological Surgery, University of California San Francisco Medical Center
c Department of Pathology, University of California San Francisco Medical Center
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FIG 1. T2* signal intensity time curves from normal cortical and background ROIs.
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FIG 2. Box plot of mitotic index labeling (MIB-1) for each tumor shows similar mean values, indicated by the small squares for both tumor types, with a larger SD for low-grade astrocytoma. Horizontal line in box indicates median.
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FIG 3. A and B, Photomicrographs from immunohistochemistry of endothelial cell marker (CD31) in low-grade gliomas (CD31 stain; original magnification, X400). Grade II astrocytoma (A) shows minimal reactivity with CD31 antibody compared with a grade II oligogdendroglioma (B), which demonstrates strong reactivity as shown by the brown staining of the vasculature.
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FIG 4. Case of a 40-year-old man with a grade II oligodendroglioma.
A and B, Axial contrast-enhanced T1-weighted (A) and FLAIR (B) MR images demonstrate a heterogeneously enhancing (black arrows), infiltrative, cortically based mass (white arrows) in the left medial superior frontal lobe.
C, Relative CBV map of the tumor shows a large focus of increased blood volume (arrow) in the tumor.
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FIG 5. Case of a 32-year-old man with a grade II astrocytoma.
A and B, Axial contrast-enhanced T1-weighted (A) and FLAIR (B) MR images demonstrate a minimally enhancing (black arrows), heterogeneous T2 hyperintense mass (white arrows) in the left deep frontal white matter.
C, Relative CBV map of the tumor shows minimally elevated blood volume in the tumor (arrow).
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FIG 6. Box plot of rCBVmax for each tumor shows a significant difference in mean rCBVmax values (small squares) between low-grade oligodendroglioma and low-grade astrocytoma, with a larger SD for low-grade oligodendroglioma. Horizontal line in box indicates median.
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FIG 7. Multiple voxels of T2* signal intensity time curves in a left superior frontal oligodendroglioma (same patient as in Fig 4) demonstrate more pronounced signal intensity decrease within the tumor (lighter shaded area) when compared with the contralateral gray matter (darker shaded area).
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