title: Prospective glioma grading using single-dose dynamic contrast-enhanced perfusion MRI.
abstract: OBJECTIVE
  To evaluate the sensitivity and specificity of single-dose dynamic contrast-enhanced (DCE) perfusion magnetic resonance imaging (MRI) in prospective evaluation of glioma grading and to correlate the relative cerebral blood volume (rCBV) values with mitotic and ki-67 indexes obtained at histopathology.
  
  
  METHODS
  A total of 53 histologically proven patients with glioma were included in this study. DCE-MRI perfusion with a single dose of contrast medium was included in brain tumour protocol and prospective grading of glioma into low and high grade was done based on a previously reported rCBV cut-off value of 3. Tumours with rCBV ≥ 3 were considered to be high grade and rCBV < 3 were considered to be low grade. The sensitivity and specificity of the cut-off value were estimated. Ki-67 and mitotic indexes were also obtained on histopathological analysis along with histological grading.
  
  
  RESULTS
  Based on pre-defined rCBV cut-off values, prospective grading of low- and high-grade glioma was achieved with a sensitivity and specificity of 97.22% and 100%, respectively. Significant correlation was found between the mitotic/ki-67 indexes and rCBV values when data for high- and low-grade tumours was combined.
  
  
  CONCLUSIONS
  DCE-MRI performed with a single dose of contrast medium is as effective as a protocol with a double-dose of contrast medium for glioma grading using 3 T MRI and could be added to the routine evaluation protocol of brain tumours.
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Jain
authors.affiliation: Philips Healthcare, Philips India Ltd, Gurgaon, India.
authors.forename: P
authors.initials: P
authors.lastname: Sahoo
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: R
authors.initials: R
authors.lastname: Tyagi
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: A
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Neurosurgery, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: R
authors.initials: R
authors.lastname: Patir
authors.affiliation: Neurosurgery, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: S
authors.initials: S
authors.lastname: Vaishya
authors.affiliation: Pathology, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: N
authors.initials: N
authors.lastname: Prakash
authors.affiliation: Pathology, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: N
authors.initials: N
authors.lastname: Vasudev
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India. Electronic address: rakeshree1@gmail.com.
authors.forename: R K
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D060787:Neoplasm Grading; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media