title: Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma.
abstract: OBJECTIVE
  Vascularity, metabolism, and histologic grade are related in gliomas but the exact determinants of these relationships are not fully defined. We used image coregistration and stereotactic biopsies to regionally compare cerebral blood volume (CBV) and (11)C-methionine (MET) uptake measurements in brain gliomas and to assess their relationship by histopathologic examination.
  
  
  METHODS
  Fourteen patients with brain gliomas underwent MR imaging, including dynamic susceptibility contrast-enhanced MR and positron-emission tomography (PET) using MET acquired in identical stereotactic conditions before biopsy. MR-based CBV maps were calculated and both CBV maps and PET images were coregistered to anatomic images. Sixty-five biopsy samples were obtained on trajectories targeted toward high MET uptake area. The following histopathologic features were semiquantified in each sample: mitotic activity, endothelial proliferation, cellular pleomorphism, and tumor necrosis. CBV and MET uptake values were measured in the biopsy area and normalized to contralateral white matter. CBV ratios were compared with MET uptake ratios, and both measurements were compared with histologic features of each sample.
  
  
  RESULTS
  CBV ratios ranged from 0.08 to 10.24 (median = 1.73), and MET uptake ratios ranged from 0.30 to 4.91 (median = 1.67). There was a positive correlation between CBV ratios and MET uptake ratios (r = 0.65, P < .001). Both CBV and MET uptake ratios were found to be significantly related to endothelial proliferation and mitotic activity (P < .01).
  
  
  CONCLUSIONS
  Within glial tumors, there is a local relationship between CBV and MET uptake measurements. Both provide indices of focal malignant activity.
authors.affiliation: Department of Radiology, Hôpital Erasme, Brussels, Belgium. nsadeghi@ulb.ac.be
authors.forename: N
authors.initials: N
authors.lastname: Sadeghi
authors.forename: I
authors.initials: I
authors.lastname: Salmon
authors.forename: C
authors.initials: C
authors.lastname: Decaestecker
authors.forename: M
authors.initials: M
authors.lastname: Levivier
authors.forename: T
authors.initials: T
authors.lastname: Metens
authors.forename: D
authors.initials: D
authors.lastname: Wikler
authors.forename: V
authors.initials: V
authors.lastname: Denolin
authors.forename: S
authors.initials: S
authors.lastname: Rorive
authors.forename: N
authors.initials: N
authors.lastname: Massager
authors.forename: D
authors.initials: D
authors.lastname: Baleriaux
authors.forename: S
authors.initials: S
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001810:Blood Volume; D001932:Brain Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D002250:Carbon Radioisotopes; D002560:Cerebrovascular Circulation; D004727:Endothelium / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D005260:Female; D005910:Glioma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008715:Methionine / Q000493:pharmacokinetics; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013238:Stereotaxic Techniques
chemical_list: D002250:Carbon Radioisotopes; D008715:Methionine