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Measurements of diagnostic examination performance and correlation analysis using microvascular leakage, cerebral blood volume, and blood flow derived from 3T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in glial tumor grading

  • Diagnostic Neuroradiology
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Abstract

Introduction

To assess the diagnostic accuracy of microvascular leakage (MVL), cerebral blood volume (CBV) and blood flow (CBF) values derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MR imaging) for grading of cerebral glial tumors, and to estimate the correlation between vascular permeability/perfusion parameters and tumor grades.

Methods

A prospective study of 79 patients with cerebral glial tumors underwent DSC-MR imaging. Normalized relative CBV (rCBV) and relative CBF (rCBF) from tumoral (rCBVt and rCBFt), peri-enhancing region (rCBVe and rCBFe), and the value in the tumor divided by the value in the peri-enhancing region (rCBVt/e and rCBFt/e), as well as MVL, expressed as the leakage coefficient K 2 were calculated. Hemodynamic variables and tumor grades were analyzed statistically and with Pearson correlations. Receiver operating characteristic (ROC) curve analyses were also performed for each of the variables.

Results

The differences in rCBVt and the maximum MVL (MVLmax) values were statistically significant among all tumor grades. Correlation analysis using Pearson was as follows: rCBVt and tumor grade, r = 0.774; rCBFt and tumor grade, r = 0.417; MVLmax and tumor grade, r = 0.559; MVLmax and rCBVt, r = 0.440; MVLmax and rCBFt, r = 0.192; and rCBVt and rCBFt, r = 0.605. According to ROC analyses for distinguishing tumor grade, rCBVt showed the largest areas under ROC curve (AUC), except for grade III from IV.

Conclusion

Both rCBVt and MVLmax showed good discriminative power in distinguishing all tumor grades. rCBVt correlated strongly with tumor grade; the correlation between MVLmax and tumor grade was moderate.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway

    Andrés Server, Till Schellhorn & Per H. Nakstad

  2. University of Oslo, Oslo, Norway

    Andrés Server & Per H. Nakstad

  3. Department of Radiology and Nuclear Medicine, Oslo University Hospital–Ullevaal, Oslo, Norway

    Bjørn A. Graff

  4. Interventional Centre, Oslo University Hospital, Oslo, Norway

    Tone E. Døli Orheim & Øystein B. Gadmar

  5. Department of Neurosurgery, Oslo University Hospital–Ullevaal, Oslo, Norway

    Roger Josefsen

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  1. Andrés Server
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Server, A., Graff, B.A., Orheim, T.E.D. et al. Measurements of diagnostic examination performance and correlation analysis using microvascular leakage, cerebral blood volume, and blood flow derived from 3T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in glial tumor grading. Neuroradiology 53, 435–447 (2011). https://doi.org/10.1007/s00234-010-0770-x

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