Perfusion Imaging of Brain Tumors Using Arterial Spin-Labeling: Correlation with Histopathologic Vascular Density

• Published in: American journal of neuroradiology : AJNR Vol. 29; no. 4; pp. 688 - 693
• Main Authors: Noguchi, T, Yoshiura, T, Hiwatashi, A, Togao, O, Yamashita, K, Nagao, E, Shono, T, Mizoguchi, M, Nagata, S, Sasaki, T, Suzuki, S.O, Iwaki, T, Kobayashi, K, Mihara, F, Honda, H
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-04-2008; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Brain; Brain Neoplasms - blood supply; Brain Neoplasms - pathology; Cell Proliferation; Cerebrospinal fluid. Spinal cord. Spinal roots. Spinal nerves; Cerebrovascular Circulation; Child; Child, Preschool; Female; Glioma - blood supply; Glioma - pathology; Hemangioma - blood supply; Hemangioma - pathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Meningeal Neoplasms - blood supply; Meningeal Neoplasms - pathology; Meningioma - blood supply; Meningioma - pathology; Microcirculation - pathology; Middle Aged; Nervous system; Neurilemmoma - blood supply; Neurilemmoma - pathology; Neurosurgery; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spin Labels; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Anatomic pathology; Nervous system diseases; Radiodiagnosis; Perfusion imaging; Central nervous system; Spin labeling; Tumor; Encephalon
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A0903

We investigated the relationship between tumor blood-flow measurement based on perfusion imaging by arterial spin-labeling (ASL-PI) and histopathologic findings in brain tumors.
We used ASL-PI to examine 35 patients with brain tumors, including 11 gliomas, 9 meningiomas, 9 schwannomas, 1 diffuse large B-cell lymphoma, 4 hemangioblastomas, and 1 metastatic brain tumor. As an index of tumor perfusion, the relative signal intensity (SI) of each tumor (%Signal intensity) was determined as a percentage of the maximal SI within the tumor per averaged SI within normal cerebral gray matter on ASL-PI. Relative vascular attenuation (%Vessel) was determined as the total microvessel area per the entire tissue area on CD-34-immunostained histopathologic specimens. MIB1 indices of gliomas were also calculated. The differences in %Signal intensity among different histopathologic types and between high- and low-grade gliomas were compared. In addition, the correlations between %Signal intensity and %Vessel or MIB1 index were evaluated in gliomas.
Statistically significant differences in %Signal intensity were observed between hemangioblastomas versus gliomas (P < .005), meningiomas (P < .05), and schwannomas (P < .005). Among gliomas, %Signal intensity was significantly higher for high-grade than for low-grade tumors (P < .05). Correlation analyses revealed significant positive correlations between %Signal intensity and %Vessel in 35 patients, including all 6 histopathologic types (rs = 0.782, P < .00005) and in gliomas (rs = 0.773, P < .05). In addition, in gliomas, %Signal intensity and MIB1 index were significantly positively correlated (rs = 0.700, P < .05).
ASL-PI may predict histopathologic vascular densities of brain tumors and may be useful in distinguishing between high- and low-grade gliomas and in differentiating hemangioblastomas from other brain tumors.