title: Role of perfusion-weighted imaging at 3T in the histopathological differentiation between astrocytic and oligodendroglial tumors.
abstract: OBJECTIVE
  The differentiation of oligodendroglial tumors from astrocytic tumors is important clinically, because oligodendroglial tumors are more chemosensitive than astrocytic tumors. This study was designed to clarify the usefulness of 3T MR perfusion imaging (PWI) in the histopathological differentiation between astrocytic and oligodendroglial tumors. This is because there is a growing interest in the diagnostic performance of 3T MR imaging, which has the advantages of a higher signal-to-noise ratio (SNR) and greater spatial and temporal resolution.
  
  
  METHODS
  This study retrospectively included 24 consecutive patients with supratentorial, WHO grade II and III astrocytic and oligodendroglial tumors (7 astrocytic, 10 oligoastrocytic, and 7 oligodendroglial tumors) that were newly diagnosed and resected between November 2006 and December 2009 at Hiroshima University Hospital. These patients underwent dynamic susceptibility contrast-enhanced (DSC) PWI relative cerebral blood volume (rCBV) measurements before treatment. Astrocytic tumors were designated as the astrocytic group, and oligoastrocytic and oligodendroglial tumors as the oligodendroglial group. The regions of interest with the maximum rCBV values within the tumors were normalized relative to the contra-lateral white matter (rCBVmax).
  
  
  RESULTS
  The average rCBVmax of astrocytic tumors (2.01±0.68) was significantly lower than that of the oligoastrocytic (4.60±1.05) and oligodendroglial tumors (6.17±0.867) (P<0.0001). A cut-off value of 3.0 allowed to differentiate the oligodendroglial group from the astrocytic group at 100% sensitivity and 87.5% specificity.
  
  
  CONCLUSIONS
  The rCBVmax values obtained from 3T MR PWI may be useful as an adjunct to the postoperative histopathological diagnosis of glioma patients.
authors.affiliation: Department of Neurosurgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. t-saitou@qc4.so-net.ne.jp
authors.forename: Taiichi
authors.initials: T
authors.lastname: Saito
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Yamasaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kajiwara
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Abe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Takako
authors.initials: T
authors.lastname: Kakuda
authors.forename: Yukio
authors.initials: Y
authors.lastname: Takeshima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Okada
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult