Prediction of malignancy grading using computed tomography perfusion imaging in nonenhancing supratentorial gliomas
Prediction of malignancy grading using computed tomography perfusion imaging in nonenhancing supratentorial gliomas
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DOI：
10.1007/s11060-010-0433-0
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发表时间：
2011-07-01
影响因子：
3.9
通讯作者：
Ogasawara, Kuniaki
中科院分区：
文献类型：
--
作者：
Beppu, Takaaki;Sasaki, Makoto;Ogasawara, Kuniaki
仅使用常规神经影像学往往难以区分肿瘤级别。计算机断层扫描灌注成像（CTP）提供了与肿瘤恶性程度密切相关的肿瘤血管系统的定量信息。本研究旨在探讨CTP是否可用于术前预测对比增强磁共振成像（MRI）显示无增强的胶质瘤的恶性程度。受试者包括17例MRI无增强幕上胶质瘤患者。术前进行CTP检查，计算参数的绝对值和标准化比值。术后，根据病理学诊断将受试者分为3级（G3）胶质瘤和2级（G2）胶质瘤两组。比较G3和G2之间每个参数的绝对值和标准化比值。评估脑血流量（nCBF）和脑血容量（nCBV）标准化比值预测G3诊断的准确性。此外，还比较了弥漫性星形细胞瘤、G2少突胶质细胞瘤（OT）和G3 OT之间的nCBV。G3和G2之间的nCBF和nCBV值差异显著。以nCBV = 1.6为界值，鉴别G3的特异性和敏感性分别为83.3%和90.9%。弥漫性星形细胞瘤和G2 OT之间的nCBV无显著差异，而G2和G3 OT之间以及弥漫性星形细胞瘤和G3 OT之间存在差异。CTP提供了一个有用的方法来区分G3和G2的非增强胶质瘤。
Tumor grade differentiation is often difficult using routine neuroimaging alone. Computed tomography perfusion imaging (CTP) provides quantitative information on tumor vasculature that closely parallels the degree of tumor malignancy. This study examined whether CTP is useful for preoperatively predicting the grade of malignancy in glioma showing no enhancement on contrast-enhanced magnetic resonance imaging (MRI). Subjects comprised 17 patients with supratentorial glioma without enhancement on MRI. CTP was performed preoperatively, and absolute values and normalized ratios of parameters were calculated. Postoperatively, subjects were classified into two groups according to histological diagnosis of grade 3 (G3) glioma or grade 2 (G2) glioma. Absolute values and normalized ratios for each parameter were compared between G3 and G2. Accuracies of normalized ratios for cerebral blood flow (nCBF) and cerebral blood volume (nCBV) in predicting a diagnosis of G3 were assessed. In addition, nCBV was compared between diffuse astrocytoma, G2 oligodendroglial tumor (OT), and G3 OT. Values for nCBF and nCBV differed significantly between G3 and G2. Using nCBV of 1.6 as a cutoff, specificity and sensitivity for distinguishing G3 were 83.3% and 90.9%, respectively. No significant difference in nCBV was seen between diffuse astrocytoma and G2 OT, whereas differences were noted between G2 and G3 OTs, and between diffuse astrocytoma and G3 OT. CTP offers a useful method for differentiating between G3 and G2 in nonenhancing gliomas.