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Perfusion MR Imaging in Differentiating High-Grade from Low-Grade Gliomas

Abstract

To correlate perfusion MR imaging with histologic grade of cerebral gliomas. Materials & Methods Relative cerebral blood volume (rCBV) maps were determined in 22 patients with pathologically proved gliomas (11 glioblastomas, 8 anaplastic gliomas and 2 low-grade gliomas) by dynamic contrast-enhanced T2*-weighted MR imaging. MR examination was completed with conventional T1- and T2-weighted imaging. The rCBV maps were calculated with an independent workstation by fitting a gamma-variate function to the contrast material concentration versus time curve. Relative CBV ratios obtained between tumor and normal white matter were compared between glioblastomas, anaplastic gliomas and low-grade gliomas by means of receiver operating characteristic (ROC) analysis. Results Mean rCBV ratios were 4.85 (\ub1 1) for glioblastomas, 3.87 (\ub1 0.7) for anaplastic gliomas and 1.65 (\ub1 1.6) for low-grade gliomas. Receiver operating characteristic analysis demonstrates significant differences between glioblastomas and anaplastic gliomas (p<.05), between anaplastic gliomas and low-grade gliomas (p<.05) and between glioblastomas and low-grade gliomas (p<.01). The rCBV ratio cutoff value between highgrade gliomas and low-grade gliomas was 2.52 with a sensitivity and specificity of 100% and 75% respectively. Conclusion Perfusion MR imaging is a reliable technique for differentiating high-grade from low-grade glioma

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