Prognostic value of perfusion-weighted imaging in brain glioma: a prospective study |
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Authors: | C Chaskis T Stadnik A Michotte K Van Rompaey J D’Haens |
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Institution: | (1) Department of Neurosurgery, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium;(2) Department of Neuroimaging, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium;(3) Department of Neuropathology, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium |
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Abstract: | Summary Object. Biopsy targeting based on MR imaging alone may fail to identify malignant areas in brain gliomas. Considering the differences
in relative Cerebral Blood Volume (rCBV) ratios reported among tumour grades, we evaluated whether perfusion-weighted MR imaging
(PWI) could usefully implement the routine preoperative imaging by detecting those areas bearing a higher yield for malignancy
to guide the stereotactic biopsy or the surgical removal.
Clinical material and methods. We studied a series of 55 consecutive patients with newly diagnosed brain glioma using both conventional MR imaging and
PWI in the preoperative assessment. The pathological diagnosis was established by stereotactic biopsy in 29 cases and by craniotomy
in 24 cases. We evaluated the patient survival to detect undergrading.
Discussion. Independent from contrast-enhancement, perfusion-weighted MR imaging improved the target selection in stereotactic biopsy
guidance and the removal of malignant areas in tumours amenable to surgery. Particularly sensitive to the perfused part of
the tumour as to small regional changes, rCBV maps allowed a better detection of malignant areas. The rCBV ratios correlated
significantly to the tumour grade and the final outcome (p < 0.01).
Conclusions. We found PWI valuable in the preoperative assessment of brain gliomas, discriminating high from low-grade gliomas. PWI can
easily be performed on widely available MR imaging systems as part of the routine imaging of gliomas. |
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Keywords: | : Glioma perfusion imaging prognosis |
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