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Paradoxical perfusion metrics of high-grade gliomas with an oligodendroglioma component: quantitative analysis of dynamic susceptibility contrast perfusion MR imaging

  • Diagnostic Neuroradiology
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Abstract

Introduction

The aim of this study is to investigate perfusion characteristics of glioblastoma with an oligodendroglioma component (GBMO) compared with conventional glioblastoma (GBM) using dynamic susceptibility contrast (DSC) perfusion magnetic resonance (MR) imaging and microvessel density (MVD).

Methods

The study was approved by the institutional review board. Newly diagnosed high-grade glioma patients were enrolled (n = 72; 20 GBMs, 14 GBMOs, 19 anaplastic astrocytomas (AAs), 13 anaplastic oligodendrogliomas (AOs), and six anaplastic oligoastrocytomas (AOAs)). All participants underwent preoperative MR imaging including DSC perfusion MR imaging. Normalized cerebral blood volume (nCBV) values were analyzed using a histogram approach. Histogram parameters were subsequently compared across each tumor subtype and grade. MVD was quantified by immunohistochemistry staining and correlated with perfusion parameters. Progression-free survival (PFS) was assessed according to the tumor subtype.

Results

GBMO displayed significantly reduced nCBV values compared with GBM, whereas grade III tumors with oligodendroglial components (AO and AOA) exhibited significantly increased nCBV values compared with AA (p < 0.001). MVD analyses revealed the same pattern as nCBV results. In addition, a positive correlation between MVD and nCBV values was noted (r = 0.633, p < 0.001). Patients with oligodendroglial tumors exhibited significantly increased PFS compared with patients with pure astrocytomas in each grade.

Conclusion

In contrast to grade III tumors, the presence of oligodendroglial components in grade IV tumors resulted in paradoxically reduced perfusion metrics and MVD. In addition, patients with GBMO exhibited a better clinical outcome compared with patients with GBM.

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Acknowledgments

This study was supported by a grant from the Korea Healthcare Technology R&D Projects, Ministry for Health, Welfare and Family Affairs (HI13C0015) and by the Research Center Program of IBS (Institute for Basic Science) in Korea.

Ethical Standards and Patient Consent

We declare that all human and animal studies have been approved by our Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that due to the retrospective nature of the study, informed consent was waived.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Leonard Sunwoo, Roh-Eul Yoo, Koung Mi Kang, Tae Jin Yun, Ji-hoon Kim, Sun-Won Park & Chul-Ho Sohn

  2. Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea

    Leonard Sunwoo & Sun-Won Park

  3. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Seung Hong Choi, Roh-Eul Yoo, Koung Mi Kang, Tae Jin Yun, Ji-hoon Kim & Chul-Ho Sohn

  4. Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea

    Seung Hong Choi

  5. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

    Tae Min Kim & Se-Hoon Lee

  6. Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea

    Chul-Kee Park

  7. Department of Pathology, Seoul National University Hospital, Seoul, Korea

    Jae-Kyung Won & Sung-Hye Park

  8. Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea

    Il Han Kim

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  1. Leonard Sunwoo
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Correspondence to Seung Hong Choi.

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Sunwoo, L., Choi, S.H., Yoo, RE. et al. Paradoxical perfusion metrics of high-grade gliomas with an oligodendroglioma component: quantitative analysis of dynamic susceptibility contrast perfusion MR imaging. Neuroradiology 57, 1111–1120 (2015). https://doi.org/10.1007/s00234-015-1569-6

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