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Research ArticleBRAIN

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

Janine M. Lupo, Soonmee Cha, Susan M. Chang and Sarah J. Nelson
American Journal of Neuroradiology June 2005, 26 (6) 1446-1454;
Janine M. Lupo
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Soonmee Cha
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Susan M. Chang
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Sarah J. Nelson
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Article Figures & Data

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  • Fig 1.
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    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).

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    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 ΔR2* curves for all voxels displayed in B, used to normalize peak height values between patients.

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    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 ΔR2* 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.

Tables

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    TABLE 1:

    Volumes of abnormality expressed as percentages of the lesion on T2-weighted imaging

    FindingGrade IIIGrade IVP Value
    Contrast enhancing9.8 ± 12.332.7 ± 18.5<.01
    No decrease in signal intensity7.6 ± 10.721.6 ± 22.7<.02
    Abnormal peak height13.0 ± 10.024.9 ± 15.8<.01
    Abnormal recovery10.1 ± 16.722.7 ± 16.9<.001
    • View popup
    TABLE 2:

    Relative peak height and recovery values in and surrounding contrast-enhancing lesions

    FindingGrade IIIGrade IVP Value
    Relative peak height
        Contrast enhancing
            Mean1.2 ± 0.82.0 ± 0.9<.5
            Maximum2.3 ± 1.66.0 ± 3.2<.002
        T2 − enhancing
            Mean1.1 ± 0.41.2 ± 0.5>.99
            Maximum5.7 ± 2.75.8 ± 2.6>.5
    Percent Recovery
        Contrast enhancing
            Mean80.4 ± 11.477.5 ± 6.7<.01
            Minimum71.1 ± 13.447.7 ± 17.6>.1
        T2 − enhancing*
            Mean83.7 ± 6.282.2 ± 4.7>.1
            Minimum56.1 ± 14.643.3 ± 18.5>.5
    • View popup
    TABLE 3:

    Relative peak height and recovery values for all voxels

    FindingGrade IIIGrade IVP Value
    Relative peak height
        Contrast enhancing1.1 ± 0.92.1 ± 1.6<.001
        T2 − enhancing1.0 ± 0.91.2 ± 1.0>.1
    Percent Recovery
        Contrast enhancing82.5 ± 10.576.4 ± 11.8<.001
        T2 − enhancing*84.9 ± 8.880.9 ± 10.6<.01
    • View popup
    TABLE 4:

    Relative peak height and recovery values for nonenhancing lesions on T2-weighted images

    FindingNonenhancing, Grade IIIT2 − Enhancing,* Grade IV
    Relative peak height
        Mean1.2 ± 0.41.2 ± 0.5
        Maximum5.7 ± 2.85.8 ± 2.6
    Recovery (%)
        Mean86.4 ± 3.482.2 ± 4.9
        Minimum58.8 ± 1243.3 ± 18.5
    • * T2 lesion excluding contrast enhancement.

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American Journal of Neuroradiology: 26 (6)
American Journal of Neuroradiology
Vol. 26, Issue 6
1 Jun 2005
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Dynamic Susceptibility-Weighted Perfusion Imaging of High-Grade Gliomas: Characterization of Spatial Heterogeneity
Janine M. Lupo, Soonmee Cha, Susan M. Chang, Sarah J. Nelson
American Journal of Neuroradiology Jun 2005, 26 (6) 1446-1454;

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Dynamic Susceptibility-Weighted Perfusion Imaging of High-Grade Gliomas: Characterization of Spatial Heterogeneity
Janine M. Lupo, Soonmee Cha, Susan M. Chang, Sarah J. Nelson
American Journal of Neuroradiology Jun 2005, 26 (6) 1446-1454;
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  • Usefulness of diffusion/perfusion-weighted MRI in patients with non-enhancing supratentorial brain gliomas: a valuable tool to predict tumour grading?
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