title: Mitotic Activity in Glioblastoma Correlates with Estimated Extravascular Extracellular Space Derived from Dynamic Contrast-Enhanced MR Imaging.
abstract: A number of parameters derived from dynamic contrast-enhanced MR imaging and separate histologic features have been identified as potential prognosticators in high-grade glioma. This study evaluated the relationships between dynamic contrast-enhanced MRI-derived parameters and histologic features in glioblastoma multiforme.
  
  
  
  Twenty-eight patients with newly presenting glioblastoma multiforme underwent preoperative imaging (conventional imaging and T1 dynamic contrast-enhanced MRI). Parametric maps of the initial area under the contrast agent concentration curve, contrast transfer coefficient, estimate of volume of the extravascular extracellular space, and estimate of blood plasma volume were generated, and the enhancing fraction was calculated. Surgical specimens were used to assess subtype and were graded (World Health Organization classification system) and were assessed for necrosis, cell density, cellular atypia, mitotic activity, and overall vascularity scores. Quantitative assessment of endothelial surface area, vascular surface area, and a vascular profile count were made by using CD34 immunostaining. The relationships between MR imaging parameters and histopathologic features were examined.
  
  
  
  High values of contrast transfer coefficient were associated with the presence of frank necrosis (P = .005). High values of the estimate of volume of the extravascular extracellular space were associated with a fibrillary histologic pattern (P < .01) and with increased mitotic activity (P < .05). No relationship was found between mitotic activity and histologic pattern, suggesting that the correlation between the estimate of volume of the extravascular extracellular space and mitotic activity was independent of the histologic pattern.
  
  
  
  A correlation between the estimate of volume of the extravascular extracellular space and mitotic activity is reported. Further work is warranted to establish how dynamic contrast-enhanced MRI parameters relate to more quantitative histologic measurements, including markers of proliferation and measures of vascular endothelial growth factor expression.
authors.affiliation: From the Departments of Neuroradiology (S.J.M., G.T., C.S., A.J.) Imaging Science and Biomedical Engineering (S.J.M., G.T., G.B., G.J.M.P., A.J.), University of Manchester, Manchester, UK. Samantha.Mills@thewaltoncentre.nhs.uk.
authors.forename: S J
authors.identifier: 0000-0002-1017-6654
authors.initials: SJ
authors.lastname: Mills
authors.affiliation: Neuropathology (D.d.P., P.P.), Salford National Health Service Foundation Trust, Salford, UK.
authors.forename: D
authors.identifier: 0000-0002-3703-0903
authors.initials: D
authors.lastname: du Plessis
authors.affiliation: Neuropathology (D.d.P., P.P.), Salford National Health Service Foundation Trust, Salford, UK.
authors.forename: P
authors.identifier: 0000-0002-7258-4848
authors.initials: P
authors.lastname: Pal
authors.affiliation: From the Departments of Neuroradiology (S.J.M., G.T., C.S., A.J.) Imaging Science and Biomedical Engineering (S.J.M., G.T., G.B., G.J.M.P., A.J.), University of Manchester, Manchester, UK.
authors.forename: G
authors.identifier: 0000-0003-1722-2235
authors.initials: G
authors.lastname: Thompson
authors.affiliation: Imaging Science and Biomedical Engineering (S.J.M., G.T., G.B., G.J.M.P., A.J.), University of Manchester, Manchester, UK.
authors.forename: G
authors.identifier: 0000-0003-2431-6563
authors.initials: G
authors.lastname: Buonacorrsi
authors.affiliation: From the Departments of Neuroradiology (S.J.M., G.T., C.S., A.J.).
authors.forename: C
authors.identifier: 0000-0003-3339-1952
authors.initials: C
authors.lastname: Soh
authors.affiliation: Imaging Science and Biomedical Engineering (S.J.M., G.T., G.B., G.J.M.P., A.J.), University of Manchester, Manchester, UK.
authors.forename: G J M
authors.identifier: 0000-0003-2934-2234
authors.initials: GJ
authors.lastname: Parker
authors.affiliation: From the Departments of Neuroradiology (S.J.M., G.T., C.S., A.J.) Imaging Science and Biomedical Engineering (S.J.M., G.T., G.B., G.J.M.P., A.J.), University of Manchester, Manchester, UK.
authors.forename: A
authors.identifier: 0000-0002-1623-0383
authors.initials: A
authors.lastname: Jackson
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005110:Extracellular Space / Q000000981:diagnostic imaging; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media