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<meta name="DC.Title" content="Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4477" />
<meta name="DC.Date" content="2015-09-17" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2016 American Society of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology.

MATERIALS AND METHODS: Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients.

RESULTS: Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas ( P &lt; .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters ( r &gt; 0.8, P &lt; .05) and between relative cerebral blood volume and microvessel area ( r = 0.6579, P &lt; .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values.

CONCLUSIONS: Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.

### Abbreviations

HGG
:   high-grade glioma
LGG
:   low-grade glioma
max
:   maximum
MVA
:   microvessel area
MVD
:   microvessel density
rCBV
:   relative cerebral blood volume
SE
:   spin-echo
VSI
:   vessel size imaging" />
<meta name="DC.Contributor" content="H.-Y. Kang" />
<meta name="DC.Contributor" content="H.-L. Xiao" />
<meta name="DC.Contributor" content="J.-H. Chen" />
<meta name="DC.Contributor" content="Y. Tan" />
<meta name="DC.Contributor" content="X. Chen" />
<meta name="DC.Contributor" content="T. Xie" />
<meta name="DC.Contributor" content="J.-Q. Fang" />
<meta name="DC.Contributor" content="S. Wang" />
<meta name="DC.Contributor" content="Y. Yang" />
<meta name="DC.Contributor" content="W.-G. Zhang" />
<meta name="article:published_time" content="2015-09-17" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters (&lt;i&gt;r&lt;/i&gt; &amp;gt; 0.8, &lt;i&gt;P&lt;/i&gt; &amp;lt; .05) and between relative cerebral blood volume and microvessel area (&lt;i&gt;r&lt;/i&gt; = 0.6579, &lt;i&gt;P&lt;/i&gt; &amp;lt; .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2015/09/17" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_pmid" content="26381565" />
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<meta name="citation_section" content="ADULT BRAIN" />
<meta name="citation_access" content="all" />
<meta name="citation_author" content="H.-Y. Kang" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="H.-L. Xiao" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="J.-H. Chen" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="Y. Tan" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="X. Chen" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="T. Xie" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="J.-Q. Fang" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="S. Wang" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="Y. Yang" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="W.-G. Zhang" />
<meta name="citation_author_institution" content="From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) and Pathology (H.-L.X.), and State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China; and Departments of Radiology (S.W.) and Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." />
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<meta name="twitter:title" content="Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology.

MATERIALS AND METHODS: Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients.

RESULTS: Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas ( P &lt; .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters ( r &gt; 0.8, P &lt; .05) and between relative cerebral blood volume and microvessel area ( r = 0.6579, P &lt; .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values.

CONCLUSIONS: Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.

### Abbreviations

HGG
:   high-grade glioma
LGG
:   low-grade glioma
max
:   maximum
MVA
:   microvessel area
MVD
:   microvessel density
rCBV
:   relative cerebral blood volume
SE
:   spin-echo
VSI
:   vessel size imaging" />
<meta name="og-title" property="og:title" content="Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2015/09/17/ajnr.A4477" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology.

MATERIALS AND METHODS: Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients.

RESULTS: Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas ( P &lt; .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters ( r &gt; 0.8, P &lt; .05) and between relative cerebral blood volume and microvessel area ( r = 0.6579, P &lt; .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values.

CONCLUSIONS: Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.

### Abbreviations

HGG
:   high-grade glioma
LGG
:   low-grade glioma
max
:   maximum
MVA
:   microvessel area
MVD
:   microvessel density
rCBV
:   relative cerebral blood volume
SE
:   spin-echo
VSI
:   vessel size imaging" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">H.-Y. Kang</span>, <span class="highwire-citation-author" data-delta="1">H.-L. Xiao</span>, <span class="highwire-citation-author" data-delta="2">J.-H. Chen</span>, <span class="highwire-citation-author" data-delta="3">Y. Tan</span>, <span class="highwire-citation-author" data-delta="4">X. Chen</span>, <span class="highwire-citation-author" data-delta="5">T. Xie</span>, <span class="highwire-citation-author" data-delta="6">J.-Q. Fang</span>, <span class="highwire-citation-author" data-delta="7">S. Wang</span>, <span class="highwire-citation-author" data-delta="8">Y. Yang</span> and <span class="highwire-citation-author" data-delta="9">W.-G. Zhang</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">September 2015,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4477 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-51218--682210839" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">H.-Y. 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