title: Perfusion computed tomography assessments of peri-enhancing brain tissue in high-grade gliomas.
abstract: OBJECTIVE
  This study was undertaken to identify tumoural infiltration of peri-enhancing brain tissue in patients with glioblastoma by means of perfusion computed tomography (PCT) parameters, cerebral blood volume (CBV) and permeability surface (PS).
  
  
  METHODS
  Eight patients with surgically treated glioblastoma who were eligible for radiotherapy and nine patients with brain metastases from lung and breast cancer underwent CT before and after injection of contrast medium. CBV and PS were calculated in the contrast-enhancing lesion area, in the area of perilesional oedema and in the normal-appearing white matter (NAWM), normalised to contralateral symmetrical areas.
  
  
  RESULTS
  No significant differences were found for normalised CBV (nCBV) and nPS in NAWM regions between metastasis and glioma. Significant differences in nPS (p<0.005) were found between the typically vasogenic oedema surrounding the metastases and signal alteration surrounding the glial neoplasm. On the contrary, no significant differences were detected in the same areas for nCBV.
  
  
  CONCLUSIONS
  PCT can analyse the histopathological substrate underlying the hypodense peritumoural halo and differentiate between vasogenic oedema and neoplastic infiltration on the basis of the PS parameter. In our study, PS was more informative than CBV. These findings can be used to integrate plans for radiation therapy and/or surgery.
authors.affiliation: SCDU Radiologia, AOU Maggiore della Carità, Università del Piemonte Orientale A. Avogadro, Novara, Italy. a.stecco@libero.it
authors.forename: A
authors.initials: A
authors.lastname: Stecco
authors.forename: F
authors.initials: F
authors.lastname: Fabbiano
authors.forename: P
authors.initials: P
authors.lastname: Amatuzzo
authors.forename: E
authors.initials: E
authors.lastname: Cignini
authors.forename: M
authors.initials: M
authors.lastname: Brambilla
authors.forename: L
authors.initials: L
authors.lastname: Masini
authors.forename: M
authors.initials: M
authors.lastname: Krengli
authors.forename: A
authors.initials: A
authors.lastname: Carriero
mesh_terms: D000704:Analysis of Variance; D001810:Blood Volume; D001932:Brain Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D002560:Cerebrovascular Circulation; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D005909:Glioblastoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media