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Research ArticleBRAIN

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
American Journal of Neuroradiology October 2007, 28 (9) 1683-1689; DOI: https://doi.org/10.3174/ajnr.A0673
S. Chawla
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S. Wang
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R.L. Wolf
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J.H. Woo
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J. Wang
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D.M. O'Rourke
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K.D. Judy
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M.S. Grady
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E.R. Melhem
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H. Poptani
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Abstract

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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American Journal of Neuroradiology: 28 (9)
American Journal of Neuroradiology
Vol. 28, Issue 9
October 2007
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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, H. Poptani
American Journal of Neuroradiology Oct 2007, 28 (9) 1683-1689; DOI: 10.3174/ajnr.A0673

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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, H. Poptani
American Journal of Neuroradiology Oct 2007, 28 (9) 1683-1689; DOI: 10.3174/ajnr.A0673
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