ASL-Perfusion for Intrinsic Brain Tumor Diagnosis. Analysis of 253 Patients.

Abstract

Purpose The aim of the study was to evaluate the role of pseudo-continuous ASL-perfusion (pCASL-perfusion) in preoperative assessing of cerebral glioma grades. Methods The study group consisted of 253 patients aged 7 to 78 years with supratentorial gliomas (65 had low-grade gliomas (LGG), 188 – high-grade gliomas (HGG)). Maximal tumor blood flow (maxTBF) in small ROIs (20 mm2 ± 10 mm2) were evaluated by subsequently normalized tumor blood flow (nTBF) calculation which was compared with normal appearing white matter of center semiovale of the contralateral hemisphere. Results TBF and nTBF values were significantly differed in HGG and LGG groups, as well as grade II and grade III gliomas; grade III and grade IV gliomas (p < 0.001). ASL-perfusion has demonstrated both high sensitivity and specificity in differentiating LGG and HGG, grade II and grade III gliomas, but low sensitivity and specificity in distinguishing grade III and grade IV gliomas. We did not observe a significant difference in TBF in astrocytomas and oligodendrogliomas. Conclusion Current results demonstrate that 3D pCASL-perfusion is an effective diagnostic tool for preoperative differentiation of low and high grade gliomas.