High-Resolution Contrast-Enhanced, Susceptibility-Weighted MR Imaging at 3T in Patients with Brain Tumors: Correlation with Positron-Emission Tomography and Histopathologic Findings

Abstract

BACKGROUND AND PURPOSE:The purpose of this work was to demonstrate susceptibility effects (SusE) in various types of brain tumors with 3T high-resolution (HR)-contrast-enhanced (CE)-susceptibility-weighted (SW)-MR imaging and to correlate SusE with positron-emission tomography (PET) and histopathology.

Semiquantitative Assessment of Intratumoral Susceptibility Signals Using Non-Contrast-Enhanced High-Field High-Resolution Susceptibility-Weighted Imaging in Patients with Gliomas: Comparison with MR Perfusion Imaging

“…[7][8][9] Recently, HR-SWI has been described as a useful tool for noninvasive glioma grading. 11,12,17 High rCBV values on perfusion imaging in tumors go hand in hand with evidence of blood products detected within the tumor matrix on HR-SWI. 10 On the other hand, probably related to the angiogenesis and increased tumor blood supply, high-grade gliomas contain a relatively large amount of deoxyhemoglobin, which generates susceptibility effects and causes signal-intensity loss.…”

“…10 On the other hand, probably related to the angiogenesis and increased tumor blood supply, high-grade gliomas contain a relatively large amount of deoxyhemoglobin, which generates susceptibility effects and causes signal-intensity loss. 11 Pinker et al 12 reported that intralesional susceptibility effects were correlated with tumor grade, as determined by PET and histopathology, and that by direct comparison of intralesional susceptibility effects with the histopathology, intratumoral susceptibility effects reflected conglomerates of tumor microvascularity. As described in previous reports, 10,11 the detection of ITSS in higher grade gliomas not only reflects tumor vascularity but also indicates considerable susceptibility in areas of macro-and micronecrosis in higher grade gliomas.…”

“…11 Pinker et al 12 reported that intralesional susceptibility effects were correlated with tumor grade, as determined by PET and histopathology, and that by direct comparison of intralesional susceptibility effects with the histopathology, intratumoral susceptibility effects reflected conglomerates of tumor microvascularity. As described in previous reports, 10,11 the detection of ITSS in higher grade gliomas not only reflects tumor vascularity but also indicates considerable susceptibility in areas of macro-and micronecrosis in higher grade gliomas. In the present study, the degree of ITSS showed a significant correlation with the value of rCBVmax in the same tumor segments.…”

“…11,12,17 Moreover, Mittal et al 10 proposed that hemorrhages can be easily distinguished from veins if HR-SWI is performed both before and after administration of contrast agent. Blood vessels will change their signal inten- sity due to the contrast agent, but signal intensity from hemorrhage will not change.…”

“…However, larger comparative studies of perfusion imaging and HR-SWI are needed to determine a more precise role of HR-SWI in the grading of cerebral neoplasms. Pinker et al 11 reported that the intratumoral susceptibility signal intensity (ITSS) on HR-SWI correlated with tumor grade as determined by positron-emission tomography (PET) studies and histopathology; therefore, this imaging technique seems to be a promising tool for noninvasive glioma grading. 12 Our hypothesis is that the detection of ITSS in higher grade gliomas not only reflects tumor vascularity but also indicates considerable susceptibility in areas of macro-and micronecrosis in higher grade gliomas.…”