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<meta name="DC.Title" content="Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas" />
<meta name="DC.Date" content="2004-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material–enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions.

METHODS: Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival.

RESULTS: Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 ± 14 months for nCBV &lt; 1.5 versus 24 ± 27 months for nCBV &gt; 1.5, P &lt; .0001) than for enhancement (mean survival 61 ± 35 months without enhancement versus 22 ± 29 months with enhancement, P = .03).

CONCLUSION: Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology." />
<meta name="DC.Contributor" content="Michael H. Lev" />
<meta name="DC.Contributor" content="Yelda Ozsunar" />
<meta name="DC.Contributor" content="John W. Henson" />
<meta name="DC.Contributor" content="Amjad A. Rasheed" />
<meta name="DC.Contributor" content="Glenn D. Barest" />
<meta name="DC.Contributor" content="Griffith R. Harsh" />
<meta name="DC.Contributor" content="Markus M. Fitzek" />
<meta name="DC.Contributor" content="E. Antonio Chiocca" />
<meta name="DC.Contributor" content="James D. Rabinov" />
<meta name="DC.Contributor" content="Andrew N. Csavoy" />
<meta name="DC.Contributor" content="Bruce R. Rosen" />
<meta name="DC.Contributor" content="Fred H. Hochberg" />
<meta name="DC.Contributor" content="Pamela W. Schaefer" />
<meta name="DC.Contributor" content="R. Gilberto Gonzalez" />
<meta name="article:published_time" content="2004-02-01" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material–enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 ± 14 months for nCBV &amp;lt; 1.5 versus 24 ± 27 months for nCBV &amp;gt; 1.5, &lt;i&gt;P&lt;/i&gt; &amp;lt; .0001) than for enhancement (mean survival 61 ± 35 months without enhancement versus 22 ± 29 months with enhancement, &lt;i&gt;P&lt;/i&gt; = .03).&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology.&lt;/p&gt;" />
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<meta name="citation_publication_date" content="2004/02/01" />
<meta name="citation_mjid" content="ajnr;25/2/214" />
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<meta name="citation_author" content="Yelda Ozsunar" />
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<meta name="citation_author" content="Amjad A. Rasheed" />
<meta name="citation_author" content="Glenn D. Barest" />
<meta name="citation_author" content="Griffith R. Harsh" />
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<meta name="twitter:title" content="Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material–enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions.

METHODS: Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival.

RESULTS: Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 ± 14 months for nCBV &lt; 1.5 versus 24 ± 27 months for nCBV &gt; 1.5, P &lt; .0001) than for enhancement (mean survival 61 ± 35 months without enhancement versus 22 ± 29 months with enhancement, P = .03).

CONCLUSION: Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology." />
<meta name="og-title" property="og:title" content="Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material–enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions.

METHODS: Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival.

RESULTS: Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 ± 14 months for nCBV &lt; 1.5 versus 24 ± 27 months for nCBV &gt; 1.5, P &lt; .0001) than for enhancement (mean survival 61 ± 35 months without enhancement versus 22 ± 29 months with enhancement, P = .03).

CONCLUSION: Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology." />
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    <title>Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas | American Journal of Neuroradiology</title>  
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      <h1 class="highwire-cite-title" id="page-title">Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Michael H. Lev</span>, <span class="highwire-citation-author" data-delta="1">Yelda Ozsunar</span>, <span class="highwire-citation-author" data-delta="2">John W. Henson</span>, <span class="highwire-citation-author" data-delta="3">Amjad A. Rasheed</span>, <span class="highwire-citation-author" data-delta="4">Glenn D. Barest</span>, <span class="highwire-citation-author" data-delta="5">Griffith R. Harsh</span>, <span class="highwire-citation-author" data-delta="6">Markus M. Fitzek</span>, <span class="highwire-citation-author" data-delta="7">E. Antonio Chiocca</span>, <span class="highwire-citation-author" data-delta="8">James D. Rabinov</span>, <span class="highwire-citation-author" data-delta="9">Andrew N. Csavoy</span>, <span class="highwire-citation-author" data-delta="10">Bruce R. Rosen</span>, <span class="highwire-citation-author" data-delta="11">Fred H. Hochberg</span>, <span class="highwire-citation-author" data-delta="12">Pamela W. Schaefer</span> and <span class="highwire-citation-author" data-delta="13">R. Gilberto Gonzalez</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2004,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">25 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">214-221; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-10363--898532928" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Michael H. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">Michael H. Lev</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">Yelda Ozsunar</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-3"><span class="name">John W. Henson</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-4"><span class="name">Amjad A. Rasheed</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-5"><span class="name">Glenn D. Barest</span><a id="xref-aff-1-5" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-6"><span class="name">Griffith R. Harsh IV</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-7"><span class="name">Markus M. Fitzek</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-8"><span class="name">E. Antonio Chiocca</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-9"><span class="name">James D. Rabinov</span><a id="xref-aff-1-6" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-10"><span class="name">Andrew N. Csavoy</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a>, </li><li class="contributor" id="contrib-11"><span class="name">Bruce R. Rosen</span><a id="xref-aff-1-7" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-12"><span class="name">Fred H. Hochberg</span><a id="xref-aff-3-2" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-13"><span class="name">Pamela W. Schaefer</span><a id="xref-aff-1-8" class="xref-aff" href="#aff-1">a</a> and </li><li class="last" id="contrib-14"><span class="name">R. Gilberto Gonzalez</span><a id="xref-aff-1-9" class="xref-aff" href="#aff-1">a</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>Departments of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Neurology, Massachusetts General Hospital and Harvard Medical School, Boston</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Department of Radiology, Adnan Menderes University, School of Medicine, Aydin, Turkey</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>University of Essen, Germany</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Radionics, Inc., Burlington, MA</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Address reprint requests to Michael H. Lev, MD, Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, Boston, MA 02114</li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/25/2/214.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 25</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2004 </div></div>
      
      
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      <div class="highwire-cite-title">Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2004, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">25 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">214-221; </span></div>
  
  
  
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      <div class="highwire-cite-title">Glial Tumor Grading and Outcome Prediction Using Dynamic Spin-Echo MR Susceptibility Mapping Compared with Conventional Contrast-Enhanced MR: Confounding Effect of Elevated rCBV of Oligodendroglimoas</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2004, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">25 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">214-221; </span></div>
  
  
  
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