title: Perfusion imaging of brain gliomas using arterial spin labeling: correlation with histopathological vascular density in MRI-guided biopsies.
abstract: BACKGROUND
  This study was designed to determine if cerebral blood flow (CBF) derived from arterial spin labeling (ASL) perfusion imaging could be used to quantitatively evaluate the microvascular density (MVD) of brain gliomas on a "point-to-point" basis by matching CBF areas and surgical biopsy sites as accurate as possible.
  
  
  METHODS
  The study enrolled 47 patients with treatment-naive brain gliomas who underwent preoperative ASL, 3D T1-weighted imaging with gadolinium contrast enhancement (3D T1C+), and T2 fluid acquisition of inversion recovery (T2FLAIR) sequences before stereotactic surgery. We histologically quantified MVD from CD34-stained sections of stereotactic biopsies and co-registered biopsy locations with localized CBF measurements. The correlation between CBF and MVD was determined using Spearman's correlation coefficient. P ≤ .05 was considered statistically significant.
  
  
  RESULTS
  Of the 47 patients enrolled in the study, 6 were excluded from the analysis because of brain shift or poor co-registration and localization of the biopsy site during surgery. Finally, 84 biopsies from 41 subjects were included in the analysis. CBF showed a statistically significant positive correlation with MVD (ρ = 0.567; P = .029).
  
  
  CONCLUSIONS
  ASL can be a useful noninvasive perfusion MR method for quantitative evaluation of the MVD of brain gliomas.
authors.affiliation: Department of Radiology, Huashan Hospital Fudan University, Mid Urumqi Road, Shanghai, 200040, People's Republic of China.
authors.forename: Di
authors.initials: D
authors.lastname: Ningning
authors.affiliation: Department of Radiology, Huashan Hospital Fudan University, Mid Urumqi Road, Shanghai, 200040, People's Republic of China.
authors.forename: Pang
authors.initials: P
authors.lastname: Haopeng
authors.affiliation: Shang Hai Gamma Knife Hospital, Shanghai, People's Republic of China.
authors.forename: Dang
authors.initials: D
authors.lastname: Xuefei
authors.affiliation: Department of Pharmacy, Binzhou Medical University Affiliated Hospital, Binzhou, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wenna
authors.affiliation: Department of Radiology, Huashan Hospital Fudan University, Mid Urumqi Road, Shanghai, 200040, People's Republic of China.
authors.forename: Ren
authors.initials: R
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, People's Republic of China.
authors.forename: Wu
authors.initials: W
authors.lastname: Jingsong
authors.affiliation: Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, People's Republic of China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Chengjun
authors.affiliation: Department of Radiology, Huashan Hospital Fudan University, Mid Urumqi Road, Shanghai, 200040, People's Republic of China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhenwei
authors.affiliation: Department of Radiology, Huashan Hospital Fudan University, Mid Urumqi Road, Shanghai, 200040, People's Republic of China. xyfeng@shmu.edu.cn.
authors.forename: Feng
authors.initials: F
authors.lastname: Xiaoyuan
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D061705:Image-Guided Biopsy; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D013113:Spin Labels
chemical_list: D003287:Contrast Media; D013113:Spin Labels; C064925:gadodiamide; D019786:Gadolinium DTPA
keywords: Arterial spin labeling; Biopsy; Cerebral blood flow; Glioma; Microvascular density