title: Perfusion, diffusion and spectroscopy values in newly diagnosed cerebral gliomas.
abstract: OBJECTIVE
  To evaluate perfusion, diffusion, and spectroscopy values in enhancing and non-enhancing lesions for patients with newly diagnosed gliomas of different grades.
  
  
  METHODS
  Sixty-seven patients with newly diagnosed glioma were entered into the study 20 grade II, 26 grade III and 21 grade IV. MR data were acquired at 1.5T and included diffusion weighted images (59/67 patients), dynamic perfusion weighted images (30/67 patients) and 3D H-1 MR spectroscopy (64/67 patients). Enhancing and non-enhancing lesions were delineated by a neuroradiologist and applied to maps of relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC), relative anisotropy (RA) and metabolite intensities.
  
  
  RESULTS
  The median rCBV within enhancing regions of grade IV gliomas was significantly elevated relative to enhancing regions in grade III gliomas and normal brain. ADC was elevated relative to normal brain, but was not significantly different between grades or between enhancing and non-enhancing regions. The RA was higher in the non-enhancing region of grade IV gliomas relative to grade II and grade III. Levels of lactate plus lipid were significantly elevated in grade IV relative to grade II and grade III gliomas. Both enhancing and non-enhancing regions in grade IV gliomas showed significant correlations between CBV, ADC and choline levels.
  
  
  CONCLUSIONS
  The data were consistent with grade IV gliomas having higher membrane turnover, increased cell density and increased vascularity within enhancing lesions. Analysis of the correlations among parameters within grade IV gliomas suggested that high vascularity (high rCBV) was correlated with increased cellularity (low ADC) and increased membrane turnover (high choline) in these lesions. The non-enhancing region of grades II and III gliomas had MR parameters consistent with increased cellularity and/or membrane turnover.
authors.affiliation: Service de Neuroradiologie, Hopital Rangueil, Toulouse, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Catalaa
authors.forename: Roland
authors.initials: R
authors.lastname: Henry
authors.forename: William P
authors.initials: WP
authors.lastname: Dillon
authors.forename: Edward E
authors.initials: EE
authors.lastname: Graves
authors.forename: Tracy R
authors.initials: TR
authors.lastname: McKnight
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Vigneron
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity