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AJNR - American Journal of Neuroradiology

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Dynamic Susceptibility-Weighted Perfusion Imaging of High-Grade Gliomas: Characterization of Spatial Heterogeneity

Janine M. Lupo^a, Soonmee Cha^a,b, Susan M. Chang^b and Sarah J. Nelson^a

^a Department of Radiology, University of California, San Francisco
^b Department of Neurological Surgery, University of California, San Francisco

View larger version (26K): [in a new window]   FIG 1. A, T2 and contrast enhancing contours overlaid on a GRE EPI and corresponding resampled T2* signal intensity time curves. B, Plot of T2* signal intensity time curve, S(t), for one voxel with red solid arrow denoting the time of contrast agent injection. C, Relative concentration curve obtained. Peak height is the distance from 1 to 2, while percent recovery represents how much the post-bolus signal (3) has recovered from the peak (2).

View larger version (15K): [in a new window]   FIG 2. A, Histogram of intensities for the first time point, used to exclude tumor, ventricles, and large vessels from normal appearing brain tissue. B, Normal voxels selected using histogram analysis. C, The model function that results from averaging R2* curves for all voxels displayed in B, used to normalize peak height values between patients.

View larger version (91K): [in a new window]   FIG 3. Example of abnormal peak height (aPH; left) and abnormal recovery (aRec; center) maps for grade IV (top) and grade III (bottom) gliomas overlaid on a T2-weighted image (top -FSE, bottom –FLAIR) and the R2* curves from which they were derived (right). The grade IV glioma demonstrates a large area of aPH (green) and aRec (magenta) near the center of the lesion while in the grade III glioma both aPH and aRec are more peripherally located.