RT Journal Article
SR Electronic
T1 Arterial Spin-Labeling and MR Spectroscopy in the Differentiation of Gliomas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1683
OP 1689
DO 10.3174/ajnr.A0673
VO 28
IS 9
A1 Chawla, S.
A1 Wang, S.
A1 Wolf, R.L.
A1 Woo, J.H.
A1 Wang, J.
A1 O'Rourke, D.M.
A1 Judy, K.D.
A1 Grady, M.S.
A1 Melhem, E.R.
A1 Poptani, H.
YR 2007
UL http://www.ajnr.org/content/28/9/1683.abstract
AB BACKGROUND AND PURPOSE: Noninvasive grading of gliomas remains a challenge despite its important role in the prognosis and management of patients with intracranial neoplasms. In this study, we evaluated the ability of cerebral blood flow (CBF)-guided voxel-by-voxel analysis of multivoxel proton MR spectroscopic imaging (1H-MRSI) to differentiate low-grade from high-grade gliomas.MATERIALS AND METHODS: A total of 35 patients with primary gliomas (22 high grade and 13 low grade) underwent continuous arterial spin-labeling perfusion-weighted imaging (PWI) and 1H-MRSI. Different regions of the gliomas were categorized as “hypoperfused,” “isoperfused,” and “hyperperfused” on the basis of the average CBF obtained from contralateral healthy white matter. 1H-MRSI indices were computed from these regions and compared between low- and high-grade gliomas. Using a similar approach, we applied a subgroup analysis to differentiate low- from high-grade oligodendrogliomas because they show different physiologic and genetic characteristics.RESULTS: Choglioma (G)/white matter (WM), GlxG/WM, and Lip+LacG/CrWM were significantly higher in the “hyperperfused” regions of high-grade gliomas compared with low-grade gliomas. ChoG/WM and Lip+LacG/CrWM were also significantly higher in the “hyperperfused” regions of high-grade oligodendrogliomas. However, metabolite ratios from the “hypoperfused” or “isoperfused” regions did not exhibit any significant differences between high-grade and low-grade gliomas.CONCLUSION: The results suggest that 1H-MRSI indices from the “hyperperfused” regions of gliomas, on the basis of PWI, may be helpful in distinguishing high-grade from low-grade gliomas including oligodendrogliomas.