Quantitative estimation of permeability surface-area product in astroglial brain tumors using perfusion CT and correlation with histopathologic grade
Quantitative estimation of permeability surface-area product in astroglial brain tumors using perfusion CT and correlation with histopathologic grade
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DOI：
10.3174/ajnr.a0899
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发表时间：
2008-04-01
影响因子：
3.5
通讯作者：
Mikkelsen, T.
中科院分区：
文献类型：
--
作者：
Jain, R.;Ellika, S. K.;Mikkelsen, T.
背景和目的：胶质瘤血管生成及其不同的血流动力学特征，这可以通过使用脑灌注CT（PCT）成像进行评估，已与胶质瘤的分级和侵袭性相关。我们的假设是，定量估计的渗透性表面积积（PS），脑血容量（CBV），脑血流量（CBF），和平均通过时间（MTT）在星形胶质细胞脑肿瘤中使用PCT将与胶质瘤分级相关。高级别胶质瘤将显示较高的PS和CBV相比，低级别glioma.MATERIALS和METHODS：PCT进行了32例患者与以前未经治疗的星形胶质细胞肿瘤（24高级别胶质瘤和8低级别胶质瘤），通过使用总的采集时间为170秒。通过使用Student或非参数Wilcoxon双样本检验，将世界卫生组织（WHO）胶质瘤分级与PCT参数绝对值进行比较。受试者工作特征（ROC）分析也做了每个parameters.Results：PS，CBV，和CBF之间的低级别和高级别肿瘤组的差异有统计学意义，低级别组显示较低的平均值比高级别组。ROC分析显示CBV（C-statistics 0.930）和PS（C-statistics 0.927）在区分低级别和高级别胶质瘤方面非常相似，并且与CBF和MTT相比具有更高的预测性。在高级别组，分化的WHO III级和IV级胶质瘤也可能通过使用PCT参数，PS显示最高的C-统计值（0.926）的ROC分析在这方面。结论：PS和CBV表现出较强的关联与胶质瘤分级，高级别胶质瘤表现出较高的PS和CBV相比，低级别胶质瘤。灌注参数，特别是PS，也可用于区分WHO III级和IV级高级别肿瘤组。
BACKGROUND AND PURPOSE: Glioma angiogenesis and its different hemodynamic features, which can be evaluated by using perfusion CT (PCT) imaging of the brain, have been correlated with the grade and the aggressiveness of gliomas. Our hypothesis was that quantitative estimation of permeability surface area product (PS), cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) in astroglial brain tumors by using PCT will correlate with glioma grade. High-grade gliomas will show higher PS and CBV as compared with low-grade gliomas.MATERIALS AND METHODS: PCT was performed in 32 patients with previously untreated astroglial tumors (24 high-grade gliomas and 8 low-grade gliomas) by using a total acquisition time of 170 seconds. World Health Organization (WHO) glioma grades were compared with PCT parameter absolute values by using Student or nonparametric Wilcoxon 2-sample tests. Receiver operating characteristic (ROC) analyses were also done for each of the parameters.RESULTS: The differences in PS, CBV, and CBF between the low- and high-grade tumor groups were statistically significant, with the low-grade group showing lower mean values than the high-grade group. ROC analyses showed that both CBV (C-statistic 0.930) and PS (C-statistic 0.927) were very similar to each other in differentiating low- and high-grade gliomas and had higher predictability compared with CBF and MTT. Within the high-grade group, differentiation of WHO grade III and IV gliomas was also possible by using PCT parameters, and PS showed the highest C-statistic value (0.926) for the ROC analyses in this regard.CONCLUSIONS: Both PS and CBV showed strong association with glioma grading, high-grade gliomas showing higher PS and CBV as compared with low-grade gliomas. Perfusion parameters, especially PS, can also be used to differentiate WHO grade III from grade IV in the high-grade tumor group.