Comparison of Multiple Parameters Obtained on 3T Pulsed Arterial Spin-Labeling, Diffusion Tensor Imaging, and MRS and the Ki-67 Labeling Index in Evaluating Glioma Grading

Abstract

BACKGROUND AND PURPOSE:Pulsed arterial spin-labeling, DTI, and MR spectroscopy provide useful data for tumor evaluation. We evaluated multiple parameters by using these pulse sequences and the Ki-67 labeling index in newly diagnosed supratentorial gliomas.

3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in the Preoperative Evaluation of Gliomas

“…Another interesting finding was that CBF max and rCBF max showed a dual relationship with the degree of malignancy in gliomas. In accordance with previous studies based on pulsed ASL and CASL, [8][9][10][11][12][13][14][15][16][17] both CBF max and rCBF max obtained from pCASL increased with increasing grade of gliomas, and gliomas with higher CBF max and rCBF max were associated with worse PFS. These findings suggest that gliomas with higher rCBF max are associated with a higher degree of malignancy.…”

“…8,9 Arterial spin-labeling (ASL) is a noninvasive MR perfusion imaging technique for obtaining CBF maps. Some previous studies based on pulsed ASL and continuous ASL (CASL) have shown that the ASL-derived CBF maps have potential value in grading gliomas 8,[10][11][12][13][14][15] and predicting their progression. 9,16,17 However, although pseudocontinuous ASL (pCASL) is considered an improved method over pulsed ASL and CASL, [18][19][20] a recent study reported that pCASL-derived CBF maps failed to accurately grade gliomas.…”

“…21 On the other hand, according to many previous studies, gliomas with higher tumor blood flow are commonly more malignant. [8][9][10][11][12][13][14][15][16][17] However, a recent study found a positive correlation between proliferation activity and levels of a hypoxia biomarker in glioblastoma (GBM), 22 suggesting that GBM with a lower blood flow might be more aggressive. Hence, the correlation between relative CBF and the grade of malignancy might be more complex in gliomas.…”

Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

“…Several researchers have argued that multiparametric MR imaging methods have the potential to improve the diagnostic performance of preoperative glioma grading. [30][31][32] Furthermore, Yoon et al 1 reported that adding FDG-PET to multiparametric MR imaging, including DWI, PWI, and MR spectroscopy, can improve the diagnostic accuracy of glioma grading. However, few studies have examined glioma grading with multiparametric imaging that included APT imaging and PWI or DWI.…”

Use of Magnetic Resonance Spectroscopy of the Brain to Differentiate Low Grade Glioma and its Clinical Relevance

“…Pulsed arterial spin-labeling and diffusion tensor imaging as additional method to MR spectroscopy seem to be very useful for predicting glioma grade [29].…”