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Research ArticleAdult Brain

Glioma Angiogenesis and Perfusion Imaging: Understanding the Relationship between Tumor Blood Volume and Leakiness with Increasing Glioma Grade

R. Jain, B. Griffith, F. Alotaibi, D. Zagzag, H. Fine, J. Golfinos and L. Schultz
American Journal of Neuroradiology November 2015, 36 (11) 2030-2035; DOI: https://doi.org/10.3174/ajnr.A4405
R. Jain
aFrom the Departments of Radiology (R.J.)
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B. Griffith
eDepartments of Radiology (B.G.)
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F. Alotaibi
bPathology (F.A., D.Z.)
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D. Zagzag
bPathology (F.A., D.Z.)
cNeurosurgery (D.Z., J.G.)
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H. Fine
dMedicine (H.F.), New York University School of Medicine, New York, New York
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J. Golfinos
cNeurosurgery (D.Z., J.G.)
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L. Schultz
fPublic Health Sciences (L.S.), Henry Ford Hospital, Detroit, Michigan.
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    Fig 1.

    A–C, Scatterplots showing different rates of change of rCBV for PS with inset sketches showing how they correspond to different stages of angiogenesis for glioma grades II, III, and IV, respectively. D, A combined scatterplot for all glioma grades showing different rates of change of rCBV for PS. Inset sketches adapted with permission from Nat Rev Cancer 2003;3:401–10.

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    Fig 2.

    Bar chart showing the ratio of rCBV to PS (rCBV/PS).

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    Fig 3.

    World Health Organization grade III glioma. A, Representative postcontrast T1-weighted axial MR image shows a large solid tumor with heterogeneous areas of enhancement. Corresponding CT perfusion CBV (B) and PS (C) maps show marked heterogeneity in different segments of the tumor (eg, ROI 5 shows markedly increased CBV) but not very high PS; and on the contrary, ROI 3 shows a marked increase of PS, but not very high CBV. This case is an example of a markedly heterogeneous tumor (as seen on postcontrast MR images), and this markedly heterogeneous imaging appearance could be due to the underlying complexity of angiogenesis. Some of this heterogeneity could be explained by a very complex interplay of CBV and PS, and these two parameters probably do not increase in perfect tandem.

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    Table 1:

    Correlation with PS

    GrouprCBV
    No.CorrP Value
    Grade II130.710.006
    Grade III180.822<.001
    Grade IV450.467.001
    ComparisonsII vs III, P = .499
    II vs IV, P = .279
    III vs IV, P = .029
    • Note:—Corr indicates correlation.

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    Table 2:

    Regression models

    GroupRegression Model for rCBVa
    Grade IIrCBV = 0.48 + 2.21 × PS
    Grade IIIrCBV = 0.91 + 1.32 × PS
    Grade IVrCBV = 2.59 + 0.38 × PS
    • ↵a rCBV = Intercept + Slope × PS.

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    Table 3:

    P Value for comparing intercepts and slopes among glioma groups

    Group ComparisonrCBV
    P Value for InterceptP Value for Slope
    Grade II vs III.565.423
    Grade II vs IV.004.095
    Grade III vs IV<.001.001
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    Table 4:

    rCBV/PS ratio

    GroupNo.rCBV/PS
    MeanSD
    Grade II133.260.98
    Grade III182.460.88
    Grade IV451.410.53
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American Journal of Neuroradiology: 36 (11)
American Journal of Neuroradiology
Vol. 36, Issue 11
1 Nov 2015
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Cite this article
R. Jain, B. Griffith, F. Alotaibi, D. Zagzag, H. Fine, J. Golfinos, L. Schultz
Glioma Angiogenesis and Perfusion Imaging: Understanding the Relationship between Tumor Blood Volume and Leakiness with Increasing Glioma Grade
American Journal of Neuroradiology Nov 2015, 36 (11) 2030-2035; DOI: 10.3174/ajnr.A4405

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Glioma Angiogenesis and Perfusion Imaging: Understanding the Relationship between Tumor Blood Volume and Leakiness with Increasing Glioma Grade
R. Jain, B. Griffith, F. Alotaibi, D. Zagzag, H. Fine, J. Golfinos, L. Schultz
American Journal of Neuroradiology Nov 2015, 36 (11) 2030-2035; DOI: 10.3174/ajnr.A4405
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