title: Glioma Angiogenesis and Perfusion Imaging: Understanding the Relationship between Tumor Blood Volume and Leakiness with Increasing Glioma Grade.
abstract: OBJECTIVE
  The purpose of this study was to investigate imaging correlates to the changes occurring during angiogenesis in gliomas. This was accomplished through in vivo assessment of vascular parameters (relative CBV and permeability surface-area product) and their changing relationship with increasing glioma grade.
  
  
  METHODS
  Seventy-six patients with gliomas underwent preoperative perfusion CT and assessment of relative CBV and permeability surface-area product. Regression analyses were performed to assess the rate of change between relative CBV and permeability surface-area product and to test whether these differed for distinct glioma grades. The ratio of relative CBV to permeability surface-area product was also computed and compared among glioma grades by using analysis of variance methods.
  
  
  RESULTS
  The rate of change in relative CBV with respect to permeability surface-area product was highest for grade II gliomas followed by grade III and then grade IV (1.64 versus 0.91 versus 0.27, respectively). The difference in the rate of change was significant between grade III and IV (P = .003) and showed a trend for grades II and IV (P = .098). Relative CBV/permeability surface-area product ratios were the highest for grade II and lowest for grade IV. The pair-wise difference among all 3 groups was significant (P < .001).
  
  
  CONCLUSIONS
  There is an increase in relative CBV more than permeability surface-area product in lower grade gliomas, whereas in grade III and especially grade IV gliomas, permeability surface-area product increases much more than relative CBV. The rate of change of relative CBV with respect to permeability surface-area product and relative CBV/permeability surface-area product ratio can serve as an imaging correlate to changes occurring at the tumor microvasculature level.
authors.affiliation: From the Departments of Radiology (R.J.) rajan.jain@nyumc.org.
authors.forename: R
authors.initials: R
authors.lastname: Jain
authors.affiliation: Departments of Radiology (B.G.).
authors.forename: B
authors.initials: B
authors.lastname: Griffith
authors.affiliation: Pathology (F.A., D.Z.).
authors.forename: F
authors.initials: F
authors.lastname: Alotaibi
authors.affiliation: Pathology (F.A., D.Z.) Neurosurgery (D.Z., J.G.).
authors.forename: D
authors.initials: D
authors.lastname: Zagzag
authors.affiliation: Medicine (H.F.), New York University School of Medicine, New York, New York.
authors.forename: H
authors.initials: H
authors.lastname: Fine
authors.affiliation: Neurosurgery (D.Z., J.G.).
authors.forename: J
authors.initials: J
authors.lastname: Golfinos
authors.affiliation: Public Health Sciences (L.S.), Henry Ford Hospital, Detroit, Michigan.
authors.forename: L
authors.initials: L
authors.lastname: Schultz
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply* / Q000473:pathology*; D002199:Capillary Permeability / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005910:Glioma / Q000098:blood supply* / Q000473:pathology*; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000473:pathology*; D055420:Perfusion Imaging; D014057:Tomography, X-Ray Computed