AJDRAJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 2007;28:1683.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A0673

ORIGINAL RESEARCH

Arterial Spin-Labeling and MR Spectroscopy in the Differentiation of Gliomas

S. Chawla, S. Wang, R.L. Wolf, J.H. Woo, J. Wang, D.M. O'Rourke, K.D. Judy, M.S. Grady, E.R. Melhem and H. Poptani

From the Departments of Radiology (S.C., S.W., R.L.W., J.H.W., J.W., E.R.M., H.P.) and Neurosurgery (D.M.O., K.D.J., M.S.G.), University of Pennsylvania, Philadelphia, Penn.

Please address correspondence to Harish Poptani, PhD, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104; e-mail: poptanih{at}uphs.upenn.edu

BACKGROUND AND PURPOSE: Noninvasive grading of gliomas remains a challenge despite its important role in the prognosis and management of patients with intracranial neoplasms. In this study, we evaluated the ability of cerebral blood flow (CBF)-guided voxel-by-voxel analysis of multivoxel proton MR spectroscopic imaging (1H-MRSI) to differentiate low-grade from high-grade gliomas.

MATERIALS AND METHODS: A total of 35 patients with primary gliomas (22 high grade and 13 low grade) underwent continuous arterial spin-labeling perfusion-weighted imaging (PWI) and 1H-MRSI. Different regions of the gliomas were categorized as "hypoperfused," "isoperfused," and "hyperperfused" on the basis of the average CBF obtained from contralateral healthy white matter. 1H-MRSI indices were computed from these regions and compared between low- and high-grade gliomas. Using a similar approach, we applied a subgroup analysis to differentiate low- from high-grade oligodendrogliomas because they show different physiologic and genetic characteristics.

RESULTS: Choglioma (G)/white matter (WM), GlxG/WM, and Lip+LacG/CrWM were significantly higher in the "hyperperfused" regions of high-grade gliomas compared with low-grade gliomas. ChoG/WM and Lip+LacG/CrWM were also significantly higher in the "hyperperfused" regions of high-grade oligodendrogliomas. However, metabolite ratios from the "hypoperfused" or "isoperfused" regions did not exhibit any significant differences between high-grade and low-grade gliomas.

CONCLUSION: The results suggest that 1H-MRSI indices from the "hyperperfused" regions of gliomas, on the basis of PWI, may be helpful in distinguishing high-grade from low-grade gliomas including oligodendrogliomas.




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J.M. Pollock, A.R. Deibler, J.H. Burdette, R.A. Kraft, H. Tan, A.B. Evans, and J.A. Maldjian
Migraine Associated Cerebral Hyperperfusion with Arterial Spin-Labeled MR Imaging
AJNR Am. J. Neuroradiol., September 1, 2008; 29(8): 1494 - 1497.
[Abstract] [Full Text] [PDF]


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