title: Facing contrast-enhancing gliomas: perfusion MRI in grade III and grade IV gliomas according to tumor area.
abstract: Tumoral neoangiogenesis characterizes high grade gliomas. Relative Cerebral Blood Volume (rCBV), calculated with Dynamic Susceptibility Contrast (DSC) Perfusion-Weighted Imaging (PWI), allows for the estimation of vascular density over the tumor bed. The aim of the study was to characterize putative tumoral neoangiogenesis via the study of maximal rCBV with a Region of Interest (ROI) approach in three tumor areas-the contrast-enhancing area, the nonenhancing tumor, and the high perfusion area on CBV map-in patients affected by contrast-enhancing glioma (grades III and IV). Twenty-one patients were included: 15 were affected by grade IV and 6 by grade III glioma. Maximal rCBV values for each patient were averaged according to glioma grade. Although rCBV from contrast-enhancement and from nonenhancing tumor areas was higher in grade IV glioma than in grade III (5.58 and 2.68; 3.01 and 2.2, resp.), the differences were not significant. Instead, rCBV recorded in the high perfusion area on CBV map, independently of tumor compartment, was significantly higher in grade IV glioma than in grade III (7.51 versus 3.78, P = 0.036). In conclusion, neoangiogenesis encompasses different tumor compartments and CBV maps appear capable of best characterizing the degree of neovascularization. Facing contrast-enhancing brain tumors, areas of high perfusion on CBV maps should be considered as the reference areas to be targeted for glioma grading.
authors.affiliation: Neuro-Oncology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy ; Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
authors.forename: Anna Luisa
authors.initials: AL
authors.lastname: Di Stefano
authors.affiliation: Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, 20148 Milan, Italy.
authors.forename: Niels
authors.identifier: 0000-0002-7792-0433
authors.initials: N
authors.lastname: Bergsland
authors.affiliation: Neuro-Oncology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy ; Neuroscience Consortium, University of Pavia, Monza Policlinico and Pavia Mondino, 27100 Pavia, Italy.
authors.forename: Giulia
authors.identifier: 0000-0001-8798-9058
authors.initials: G
authors.lastname: Berzero
authors.affiliation: Neuroradiological Department, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Farina
authors.affiliation: Neuroradiological Department, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Rognone
authors.affiliation: General Neurology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Gastaldi
authors.affiliation: Department of Neuroradiology, IRCCS Foundation Neurological Institute C. Besta, 20133 Milan, Italy.
authors.forename: Domenico
authors.identifier: 0000-0002-1289-9573
authors.initials: D
authors.lastname: Aquino
authors.affiliation: Department of Neurosurgery, IRCCS Neuromed, Pozzilli (IS), University of Rome La Sapienza, 00185 Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frati
authors.affiliation: Department of Neurosurgery, University of Messina, 98122 Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomasello
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy ; General Neurology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Ceroni
authors.affiliation: Neuro-Oncology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchioni
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy ; Neuroradiological Department, C. Mondino National Neurological Institute, 27100 Pavia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bastianello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001932:Brain Neoplasms / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D055815:Young Adult