AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on September 24, 2007
doi: 10.3174/ajnr.A0688
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Role of Perfusion CT in Glioma Grading and Comparison with Conventional MR Imaging Features

S.K. Ellikaa, R. Jaina, S.C. Patela, L. Scarpaceb, L.R. Schultzc, J.P. Rockb and T. Mikkelsenb

a Division of Neuroradiology, Department of Radiology, Henry Ford Health System, Detroit, Mich
b Departments of Neurology and Neurosurgery, Henry Ford Health System, Detroit, Mich
c Departments of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Mich


Figure 1
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  		Fig 1. A, Postcontrast T1-weighted axial image in a 46-year-old man with WHO grade IV glioma showing a markedly enhancing bifrontal necrotic tumor with involvement of the genu of the corpus callosum and surrounding perilesional white matter edema. B, PCT CBV map showing elevated blood volume (nCBV = 4.3). C, CBF map showing elevated blood flow (nCBF = 6.27). D, MTT map showing decreased MTT (nMTT = 0.63) within the tumor.


Figure 2
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  		Fig 2. WHO grade III glioma in a 39-year-old woman. A, Postcontrast T1-weighted axial image showing a large heterogeneously enhancing left temporal mass lesion with significant mass effect. B, Corresponding CBV map showing elevated blood volume (nCBV = 2.61). C, CBF map showing increased blood flow (nCBF = 1.65). D, MTT map showing decreased MTT (nMTT = 1.68) within the tumor. Also note the mismatch between areas of increased blood volume/blood flow on the CBV/CBF maps and the areas of gadolinium enhancement.


Figure 3
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  		Fig 3. A 34-year-old man with WHO grade II glioma. A, Postcontrast T1-weighted axial image showing a nonenhancing mass in the right frontal lobe. B, CBV map showing low blood volume (nCBV = 0.94). C, CBF map showing decreased blood flow (nCBF = 1.26). D, MTT map showing increased transit time (nMTT = 1.07) within the tumor.


Figure 4
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  		Fig 4. Scatter plot for nCBV versus grade of tumor showing the threshold to differentiate low- from high-grade tumors.


Figure 5
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  		Fig 5. Scatter plot for nCBF versus grade of tumor showing the threshold to differentiate low- from high-grade tumors.


Figure 6
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  		Fig 6. Scatter plot for nMTT versus grade of tumor showing the threshold to differentiate low- from high-grade tumors.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X