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AJNR - American Journal of Neuroradiology

Published ahead of print on January 17, 2008
doi: 10.3174/ajnr.A0899

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Quantitative Estimation of Permeability Surface-Area Product in Astroglial Brain Tumors Using Perfusion CT and Correlation with Histopathologic Grade

R. Jain^a, S.K. Ellika^a, L. Scarpace^b, L.R. Schultz^c, J.P. Rock^b, J. Gutierrez^d, S.C. Patel^a, J. Ewing^e and T. Mikkelsen^b

^a From the Division of Neuroradiology, Department of Radiology, Henry Ford Hospital, Detroit, Mich
^b Department of Neurosurgery, Henry Ford Hospital, Detroit, Mich
^c Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, Mich
^d Department of Pathology, Henry Ford Hospital, Detroit, Mich
^e Department of Neurology, Henry Ford Hospital, Detroit, Mich

View larger version (5K): [in this window] [in a new window]   Fig 1. Box and whisker graph showing PS (A) and CBV (B) for low-versus-high-grade astroglial tumors.

View larger version (27K): [in this window] [in a new window]   Fig 2. A and B, Postcontrast T1-weighted (TR/TE, 3059/6.35 ms) axial image (A) and base image from perfusion CT study (B) in 32-year-old woman with WHO grade II astrocytoma showing a nonenhancing right frontal tumor with no surrounding perilesional edema. C and D, PS (C) and CBV (D) perfusion CT maps showing low permeability (PS = 0.7 mL/100 g per minute) and low blood volume (CBV = 1.01 mL/100 g) within the tumor.

View larger version (31K): [in this window] [in a new window]   Fig 3. A, Postcontrast T1-weighted (TR/TE, 3218/5.71 ms) axial image in a 55-year-old man with glioblastoma multiforme showing a heterogeneously enhancing mass with irregular central necrosis in the right peritrigonal region. B, Base image from the perfusion CT study showing the tumor in the right peritrigonal region. C, Perfusion CT PS maps (C) showing very high permeability (PS = 5.14 mL/100 g per minute) along the enhancing nodular margins of the tumor and CBV maps (D) showing high blood volume (CBV = 3.49 mL/100 g) within the enhancing periphery of the tumor.

View larger version (28K): [in this window] [in a new window]   Fig 4. A and B, Postcontrast T1-weighted (TR/TE, 650/13 ms) axial image (A) and base image from perfusion CT study (B) in a 46-year-old man with a heterogeneously enhancing mass lesion predominantly involving the right frontal lobe with extension across the genu of the corpus callosum. C and D, Perfusion CT PS (C) and CBV (D) maps showing high permeability (PS = 2.04 mL/100 g per minute) and tumor blood volume (CBV = 2.21 mL/100 g). Histopathology revealed a grade III anaplastic astrocytoma.

View larger version (32K): [in this window] [in a new window]   Fig 5. A and B, Postcontrast T1-weighted (TR/TE, 3103/6.35 ms) image (A) and base image from perfusion CT study (B) in a 31-year-old man who presented with memory impairment and speech problems showing a nonenhancing mass in the left temporal lobe with minimal mass effect and perilesional edema. C and D, PS (C) and CBV (D) maps showing low permeability (PSA = 0.61 mL/100 g per minute) and low blood volume (CBV = 0.92 mL/100 g) within the mass. Histopathology revealed grade III anaplastic astrocytoma.