PT  - JOURNAL ARTICLE
AU  - S.J. Price
AU  - H.A.L. Green
AU  - A.F. Dean
AU  - J. Joseph
AU  - P.J. Hutchinson
AU  - J.H. Gillard
TI  - Correlation of MR Relative Cerebral Blood Volume Measurements with Cellular Density and Proliferation in High-Grade Gliomas: An Image-Guided Biopsy Study
AID  - 10.3174/ajnr.A2312
DP  - 2011 Mar 01
TA  - American Journal of Neuroradiology
PG  - 501--506
VI  - 32
IP  - 3
4099  - http://www.ajnr.org/content/32/3/501.short
4100  - http://www.ajnr.org/content/32/3/501.full
SO  - Am. J. Neuroradiol.2011 Mar 01; 32
AB  - BACKGROUND AND PURPOSE: As newer MR imaging techniques are used to assist with tumor grading, biopsy planning, and therapeutic response assessment, there is a need to relate the imaging characteristics to underlying pathologic processes. The aim of this study was to see how rCBV, a known marker of tumor vascularity, relates to cellular packing attenuation and cellular proliferation. MATERIALS AND METHODS: Nine patients with histologically proved high-grade gliomas and 1 with a supratentorial PNET requiring an image-guided biopsy were recruited. Patients underwent a DSC study. The rCBV at the intended biopsy sites was determined by using a histogram measure to derive the mean, maximum, and 75th centile and 90th centile values. This measure was correlated with histologic markers of the MIB-1 labeling index (as a marker of glioma cell proliferation) and the total number of neoplastic cells in a high-power field (cellular packing attenuation). RESULTS: There was a good correlation between rCBV and MIB-1 by using all the measures of rCBV. The mean rCBV provided the best results (r = 0.66, P < .001). The only correlation with cellular packing attenuation was with the 90% centile (rCBV90%, r = 0.36, P = .03). The increase in rCBV could be seen over 1 cm from the edge of enhancement in 4/10 cases, and at 2 cm in 1/10. CONCLUSIONS: rCBV correlated with cellular proliferation in high-grade gliomas but not with cellular packing attenuation. The increase in rCBV extended beyond the contrast-enhancing region in 50% of our patients. CBVcerebral blood volumeDSCdynamic susceptibility-weighted contrast-enhanced perfusion MR imagingmaxmaximumMIB-1a monoclonal antibody directed against the Ki-67 antigenNSnot significantPETpositron-emission tomographyPNETprimitive neuroectodermal tumorrCBVrelative CBVrCBV75%75th percentile CBVrCBV90%90th percentile rCBVrCBVmaxmaximum rCBVrCBVmeanmean rCBVSPGRspoiled gradient-recalledVEGFvascular endothelial growth factorWHOWorld Health Organization