title: Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas.
abstract: OBJECTIVE Arterial spin labeling perfusion-weighted imaging (ASL-PWI) enables quantification of tissue perfusion without contrast media administration. The aim of this study was to explore whether cerebral blood flow (CBF) from ASL-PWI can reliably predict angiographic vascularity of meningiomas. METHODS Twenty-seven patients with intracranial meningiomas, who had undergone preoperative ASL-PWI and digital subtraction angiography prior to resection, were included. Angiographic vascularity was assessed using a 4-point grading scale and meningiomas were classified into 2 groups: low vascularity (Grades 0 and 1; n = 11) and high vascularity (Grades 2 and 3; n = 16). Absolute CBF, measured at the largest section of the tumor, was normalized to the contralateral gray matter. Correlation between the mean normalized CBF (nCBF) and angiographic vascularity was determined and the mean nCBF values of the 2 groups were compared. Diagnostic performance of the nCBF for differentiating between the 2 groups was assessed. RESULTS The nCBF had a significant positive correlation with angiographic vascularity (ρ = 0.718; p < 0.001). The high-vascularity group had a significantly higher nCBF than the low-vascularity group (3.334 ± 2.768 and 0.909 ± 0.468, respectively; p = 0.003). At the optimal nCBF cutoff value of 1.733, sensitivity and specificity for the differential diagnosis of the 2 groups were 69% (95% CI 41%-89%) and 100% (95% CI 72%-100%), respectively. The area under the receiver operating characteristic curve was 0.875 (p < 0.001). CONCLUSIONS ASL-PWI may provide a reliable and noninvasive means of predicting angiographic vascularity of meningiomas. It may thus assist in selecting potential candidates for preoperative digital subtraction angiography and embolization in clinical practice.
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;
authors.forename: Roh-Eul
authors.initials: RE
authors.lastname: Yoo
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.affiliation: Departments of 1 Radiology and.
authors.forename: Jung Hyo
authors.initials: JH
authors.lastname: Rhim
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;
authors.forename: Koung Mi
authors.initials: KM
authors.lastname: Kang
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;|Institute of Radiation Medicine, Seoul National University Medical Research Center; and.
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Neurosurgery, Seoul National University Hospital;
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Neurosurgery, Seoul National University Hospital;
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;|Institute of Radiation Medicine, Seoul National University Medical Research Center; and.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Department of Radiology, Seoul National University College of Medicine;|Department of Radiology, Boramae Medical Center, Seoul, Korea.
authors.forename: Sun-Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Departments of 1 Radiology and.|Department of Radiology, Seoul National University College of Medicine;|Institute of Radiation Medicine, Seoul National University Medical Research Center; and.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging*; D008579:Meningioma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013113:Spin Labels
chemical_list: D003287:Contrast Media; D013113:Spin Labels
keywords: ASL-PWI = arterial spin labeling perfusion-weighted imaging; CBF = cerebral blood flow; DSA = digital subtraction angiography; ECA = external carotid artery; ICA = internal carotid artery; ROC = receiver operating characteristic; angiographic vascularity; arterial spin labeling; meningiomas; nCBF = normalized CBF; oncology; perfusion magnetic resonance imaging