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Research ArticleADULT BRAIN
Open Access

3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in the Preoperative Evaluation of Gliomas

Q. Zeng, B. Jiang, F. Shi, C. Ling, F. Dong and J. Zhang
American Journal of Neuroradiology July 2017, DOI: https://doi.org/10.3174/ajnr.A5299
Q. Zeng
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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B. Jiang
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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F. Shi
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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C. Ling
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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F. Dong
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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J. Zhang
From the Departments of Neurosurgery (Q.Z., C.L., J.Z.), Radiology (B.J., F.D.), and Neurology (F.S.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; and Brain Research Institute (J.Z.) and Collaborative Innovation Center for Brain Science (J.Z.), Zhejiang University, Hangzhou, Zhejiang, China.
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Abstract

BACKGROUND AND PURPOSE: Previous studies showed conflicting results concerning the value of CBF maps obtained from arterial spin-labeling MR imaging in grading gliomas. This study was performed to investigate the effectiveness of CBF maps derived from 3D pseudocontinuous arterial spin-labeling in preoperatively assessing the grade, cellular proliferation, and prognosis of gliomas.

MATERIALS AND METHODS: Fifty-eight patients with pathologically confirmed gliomas underwent preoperative 3D pseudocontinuous arterial spin-labeling. The receiver operating characteristic curves for parameters to distinguish high-grade gliomas from low-grade gliomas were generated. Pearson correlation analysis was used to assess the correlation among parameters. Survival analysis was conducted with Cox regression.

RESULTS: Both maximum CBF and maximum relative CBF were significantly higher in high-grade gliomas than in low-grade gliomas (P < .001). The areas under the curve for maximum CBF and maximum relative CBF in distinguishing high-grade gliomas from low-grade gliomas were 0.828 and 0.863, respectively. Both maximum CBF and maximum relative CBF had no correlation with the Ki-67 index in all subjects and had a moderate negative correlation with the Ki-67 index in glioblastomas (r = −0.475, −0.534, respectively). After adjustment for age, a higher maximum CBF (P = .008) and higher maximum relative CBF (P = .005) were associated with worse progression-free survival in gliomas, while a higher maximum relative CBF (P = .033) was associated with better overall survival in glioblastomas.

CONCLUSIONS: 3D pseudocontinuous arterial spin-labeling–derived CBF maps are effective in preoperative evaluation of gliomas. Although gliomas with a higher blood flow are more malignant, glioblastomas with a lower blood flow are likely to be more aggressive.

Abbreviations

ASL
arterial spin-labeling
CASL
continuous ASL
GBM
glioblastoma
HGG
high-grade glioma
HR
hazard ratio
KPS
Karnofsky Performance Scale
LGG
low-grade glioma
max
maximum
OS
overall survival
pCASL
pseudocontinuous ASL
PFS
progression-free survival
ROC
receiver operating characteristic
WHO
World Health Organization
  • © 2017 American Society of Neuroradiology

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3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in the Preoperative Evaluation of Gliomas
Q. Zeng, B. Jiang, F. Shi, C. Ling, F. Dong, J. Zhang
American Journal of Neuroradiology Jul 2017, DOI: 10.3174/ajnr.A5299

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3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in the Preoperative Evaluation of Gliomas
Q. Zeng, B. Jiang, F. Shi, C. Ling, F. Dong, J. Zhang
American Journal of Neuroradiology Jul 2017, DOI: 10.3174/ajnr.A5299
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