title: Dynamic contrast-enhanced derived cerebral blood volume correlates better with leak correction than with no correction for vascular endothelial growth factor, microvascular density, and grading of astrocytoma.
abstract: OBJECTIVE
  To look for the impact of leak correction on correlation of perfusion indices with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in astrocytomas.
  
  
  METHODS
  Dynamic contrast-enhanced magnetic resonance imaging was performed in 64 patients with varying grades of astrocytoma. Perfusion indices (ie, relative cerebral blood volume (rCBV) with and without leak correction, relative cerebral blood flow (rCBF), permeability (k(trans)), and leakage (v(e)) were quantified. MVD and VEGF-expressing cells were quantified from the excised tumor tissues and were correlated with perfusion metrics.
  
  
  RESULTS
  Perfusion indices showed significant difference among the astrocytoma grades. The corrected rCBV correlated better with MVD and VEGF. The corrected rCBV correlated (r = 0.853, P = <0.001) strongly, whereas the uncorrected rCBV (r = 0.592, P = <0.001) and k(trans) (r = 0.498, P = 0.001) correlated moderately with tumor grade. The corrected rCBV discriminated 100% low-grade from high-grade astrocytoma, while uncorrected rCBV did this in 95.5% low-grade and 71.4% high-grade astrocytoma.
  
  
  CONCLUSIONS
  Corrected rCBV better correlates with grade and is more accurate in discriminating low-grade from high-grade astrocytoma compared with uncorrected rCBV.
authors.affiliation: Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Haris
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Husain
authors.forename: Anup
authors.initials: A
authors.lastname: Singh
authors.forename: Mazhar
authors.initials: M
authors.lastname: Husain
authors.forename: Savita
authors.initials: S
authors.lastname: Srivastava
authors.forename: Chhitiz
authors.initials: C
authors.lastname: Srivastava
authors.forename: Sanjay
authors.initials: S
authors.lastname: Behari
authors.forename: Ram Kishore S
authors.initials: RK
authors.lastname: Rathore
authors.forename: Sona
authors.initials: S
authors.lastname: Saksena
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D016477:Artifacts; D001254:Astrocytoma / Q000473:pathology*; D001932:Brain Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000378:metabolism*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008833:Microcirculation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D003287:Contrast Media; D042461:Vascular Endothelial Growth Factor A; D019786:Gadolinium DTPA