Perfusion imaging of brain tumors using arterial spin-labeling: correlation with histopathologic vascular density.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Noguchi
T
T
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. tnogucci@radiol.med.kyushu-u.ac.jp
Yoshiura
T
T
Hiwatashi
A
A
Togao
O
O
Yamashita
K
K
Nagao
E
E
Shono
T
T
Mizoguchi
M
M
Nagata
S
S
Sasaki
T
T
Suzuki
S O
SO
Iwaki
T
T
Kobayashi
K
K
Mihara
F
F
Honda
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply* / Q000473:pathology; D049109:Cell Proliferation; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000098:blood supply / Q000473:pathology; D006391:Hemangioma / Q000098:blood supply / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000473:pathology; D008579:Meningioma / Q000098:blood supply / Q000473:pathology; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009442:Neurilemmoma / Q000098:blood supply / Q000473:pathology; D013113:Spin Labels
D013113:Spin Labels