AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on November 1, 2007
doi: 10.3174/ajnr.A0794
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Predicting Grade of Cerebral Glioma Using Vascular-Space Occupancy MR Imaging

H. Lua,c, E. Pollacka, R. Younga, J.S. Babba, G. Johnsona, D. Zagzagb, R. Carsona,d, J.H. Jensena, J.A. Helperna and M. Lawa,d,e

a Department of Radiology, New York University School of Medicine, New York, NY
b Department of Pathology, New York University School of Medicine, New York, NY
c Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex
d Department of Radiology, Mount Sinai Medical Center, New York, NY
e Department of Neurosurgery, Mount Sinai Medical Center, New York, NY


Figure 1
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  		Fig 1. Schematic diagram of the VASO scans and the VASO pulse sequence. VASO uses a nonselective inversion recovery sequence, and the TI is chosen to null the precontrast blood signal intensity. Two scans using identical parameters are performed before and after the contrast agent administration, the signal intensity difference of which can be used to calculate absolute CBV.


Figure 2
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  		Fig 2. T2-weighted, CE-T1-weighted, and FLAIR images, as well as VASO maps for WHO grade II, III, and IV gliomas.


Figure 3
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  		Fig 3. Three VASO indices, that is, VASOTumor, VASOContra, and VASORatio, in grade II (n = 9), III (n = 20), and IV (n = 10) gliomas. Error bars indicate SDs. The units for VASOTumor and VASOContra are percentages. The index VASORatio is dimensionless. Significant differences (P < .05) for each pair are indicated by asterisks.


Figure 4
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  		Fig 4. ROC curves using VASOTumor or VASORatio. The sensitivity and specificity (in fractions) in terms of distinguishing grade II from higher-grade (grade III and grade IV) tumors are plotted at different thresholds. If the 2 categories have identical distributions of the VASO parameters, the ROC curve would have been a 45° straight line (dotted line). The AUCs are 0.974 and 0.985 for VASOTumor and VASORatio, respectively.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X