title: Measurements of diagnostic examination performance and correlation analysis using microvascular leakage, cerebral blood volume, and blood flow derived from 3T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in glial tumor grading.
abstract: BACKGROUND
  To assess the diagnostic accuracy of microvascular leakage (MVL), cerebral blood volume (CBV) and blood flow (CBF) values derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MR imaging) for grading of cerebral glial tumors, and to estimate the correlation between vascular permeability/perfusion parameters and tumor grades.
  
  
  METHODS
  A prospective study of 79 patients with cerebral glial tumors underwent DSC-MR imaging. Normalized relative CBV (rCBV) and relative CBF (rCBF) from tumoral (rCBVt and rCBFt), peri-enhancing region (rCBVe and rCBFe), and the value in the tumor divided by the value in the peri-enhancing region (rCBVt/e and rCBFt/e), as well as MVL, expressed as the leakage coefficient K(2) were calculated. Hemodynamic variables and tumor grades were analyzed statistically and with Pearson correlations. Receiver operating characteristic (ROC) curve analyses were also performed for each of the variables.
  
  
  RESULTS
  The differences in rCBVt and the maximum MVL (MVL(max)) values were statistically significant among all tumor grades. Correlation analysis using Pearson was as follows: rCBVt and tumor grade, r = 0.774; rCBFt and tumor grade, r = 0.417; MVL(max) and tumor grade, r = 0.559; MVL(max) and rCBVt, r = 0.440; MVL(max) and rCBFt, r = 0.192; and rCBVt and rCBFt, r = 0.605. According to ROC analyses for distinguishing tumor grade, rCBVt showed the largest areas under ROC curve (AUC), except for grade III from IV.
  
  
  CONCLUSIONS
  Both rCBVt and MVL(max) showed good discriminative power in distinguishing all tumor grades. rCBVt correlated strongly with tumor grade; the correlation between MVL(max) and tumor grade was moderate.
authors.affiliation: Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway. a.s.alonso@medisin.uio.no
authors.forename: Andrés
authors.initials: A
authors.lastname: Server
authors.forename: Bjørn A
authors.initials: BA
authors.lastname: Graff
authors.forename: Tone E Døli
authors.initials: TE
authors.lastname: Orheim
authors.forename: Till
authors.initials: T
authors.lastname: Schellhorn
authors.forename: Roger
authors.initials: R
authors.lastname: Josefsen
authors.forename: Øystein B
authors.initials: ØB
authors.lastname: Gadmar
authors.forename: Per H
authors.initials: PH
authors.lastname: Nakstad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D060787:Neoplasm Grading; D010477:Perfusion; D011446:Prospective Studies
chemical_list: D003287:Contrast Media