title: Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading.
abstract: OBJECTIVE
  Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology.
  
  
  METHODS
  Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients.
  
  
  RESULTS
  Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas (P < .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters (r > 0.8, P < .05) and between relative cerebral blood volume and microvessel area (r = 0.6579, P < .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values.
  
  
  CONCLUSIONS
  Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: H-Y
authors.initials: HY
authors.lastname: Kang
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) Pathology (H.-L.X.).
authors.forename: H-L
authors.initials: HL
authors.lastname: Xiao
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: J-H
authors.initials: JH
authors.lastname: Chen
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: Y
authors.initials: Y
authors.lastname: Tan
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: T
authors.initials: T
authors.lastname: Xie
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.).
authors.forename: J-Q
authors.initials: JQ
authors.lastname: Fang
authors.affiliation: Departments of Radiology (S.W.).
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.affiliation: Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China wgzhang01@163.com.
authors.forename: W-G
authors.initials: WG
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005910:Glioma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging / Q000473:pathology; D060787:Neoplasm Grading / Q000379:methods*; D055420:Perfusion Imaging / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity