Perfusion imaging of brain gliomas using arterial spin labeling: correlation with histopathological vascular density in MRI-guided biopsies

Di, Ningning; Pang, Haopeng; Dang, Xuefei; Cheng, Wenna; Ren, Yan; Wu, Jiang; Yao, Chengjun; Yao, Zhenwei; Feng, Xiaoyuan

doi:10.1007/s00234-016-1756-0

Cited by 27 publications

(15 citation statements)

References 35 publications

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“…Volume of biopsy sample was 300-900 mm 3 . All 37 patients had gliomas confirmed by pathology, which consisted of 20 HGG patients with mean age 49 ± 11 years, and 17 LGG patients with mean age 43 ± 15 years (Table 1). Age difference between HGG and LGG patients was not significant (P = 0.165, two tails).…”

Section: Patient Groups and Tissue Samplesmentioning

confidence: 99%

“…Dynamic susceptibility contrast‐enhanced MR (DSC‐MR) perfusion has been employed to assess microvessel area . Recent studies have shown that ASL can also be used to measure microvascular density in glioma and nonfunctioning pituitary macroadenoma . In addition, relationships have been established between VEGF expression and parameters derived from contrast media‐dependent MR perfusion techniques, such as DSC‐MR and T 1 ‐weighted dynamic contrast‐enhanced MRI in glioma, meningioma, and rectal carcinoma .…”

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confidence: 99%

“…15,16 Recent studies have shown that ASL can also be used to measure microvascular density in glioma and nonfunctioning pituitary macroadenoma. 6,17,18 In addition, relationships have been established between VEGF expression and parameters derived from contrast media-dependent MR perfusion techniques, such as DSC-MR and T 1 -weighted dynamic contrast-enhanced MRI in glioma, meningioma, and rectal carcinoma. [19][20][21] MR perfusion means that demand injection of contrast agent to assess VEGF expression or microvascular morphology based on nonlocalizing surgical specimens has been investigated.…”

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confidence: 99%

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3D‐ASL perfusion correlates with VEGF expression and overall survival in glioma patients: Comparison of quantitative perfusion and pathology on accurate spatial location‐matched basis

Pang

Dang

Ren

et al. 2019

Magnetic Resonance Imaging

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Background There is a need for an imaging‐based tool for measuring vascular endothelial growth factor (VEGF) expression and overall survival (OS) in patients with glioma. Purpose To assess the correlation between cerebral blood flow (CBF), measured by 3D pseudo‐continuous arterial spin‐labeling (3D‐ASL), and VEGF expression in gliomas on the basis of coregistered localized biopsy, and investigate whether CBF correlated with survival month (SM) in glioma patients. Study Type Prospective cohort. Subjects Thirty‐seven patients with gliomas from whom 63 biopsy specimens were obtained. Sequence 3D‐ASL acquired with a 3.0T MR unit. Assessment Biopsy specimens were grouped as high‐grade (HGG) or low‐grade glioma (LGG). CBF measurements were spatially matched with VEGF expression by coregistered localized biopsies, and the CBF value was correlated with quantitative VEGF expression for each specimen. Patients' survival information was derived and connected with CBF. Statistical Tests Patients' OS was analyzed by Kaplan–Meier and Cox‐regression methods. VEGF expression and CBF were compared in both LGG and HGG. The Spearman rank correlation was calculated for CBF and VEGF expression, SM. Significance level, P < 0.05. Results CBF‐derived 3D‐ASL positively correlated significantly with VEGF expression in both LGG (31 specimens) and HGG (32 specimens), r = 0.604 (P < 0.001) and r = 0.665 (P < 0.001), respectively. LGG and HGG together gave a correlation coefficient r = 0.728 (P < 0.001). Median survival for LGG and HGG patients was 34.19 and 17.17 months, respectively (P = 0.037); CBF value negatively correlated significantly with SM with r = –0.714 (P < 0.001) regardless of glioma grade. CBF was an independent risk factor for OS with HR = 1.027 (P = 0.044), 1.028 (P = 0.010) for univariate/multivariate regression analysis. Data Conclusion CBF determined by 3D‐ASL correlates with VEGF expression in glioma and is an independent risk factor for OS in these patients. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:209–220.

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Section: Patient Groups and Tissue Samplesmentioning

confidence: 99%

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3D‐ASL perfusion correlates with VEGF expression and overall survival in glioma patients: Comparison of quantitative perfusion and pathology on accurate spatial location‐matched basis

Pang

Dang

Ren

et al. 2019

Magnetic Resonance Imaging

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“…Several researches have shown that ASL can help discriminate high- and low-grade gliomas [7], [8]. Although some studies [9], [10], [11], [12] suggested that CBF obtained from ASL may have relationships with histopathologic parameters, such as vascular density and epidermal growth factor receptor status. Few studies focus on the correlations of perfusion with IDH1 genotype and 1p/19q status.…”

Section: Introductionmentioning

confidence: 99%

Arterial Spin Labeling for Glioma Grade Discrimination: Correlations with IDH1 Genotype and 1p/19q Status

Wang

Xie

Liu

et al. 2019

Translational Oncology

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Since accurate grading of gliomas has important clinical value, the aim of this study is to evaluate the diagnostic efficacy of perfusion values derived from arterial spin labeling (ASL) to grade gliomas. In addition, the correlation between perfusion and isocitrate dehydrogenase 1 (IDH1) genotypes and chromosome arms 1p and 19q (1p/19q) status of gliomas was assessed. A total of 52 cases of supratentorial gliomas in adults who received ASL imaging were enrolled in this retrospective study. The cerebral blood flow (CBF) images derived from ASL and anatomical maps were normalized to the Montreal Neurological Institute coordinate system and matched. The mean CBF (meanCBF), the maximum CBF (maxCBF), and their relative values (rmeanCBF and rmaxCBF, respectively) were assessed in each case. The tumor grades, IDH1 genotypes, and 1p/19q status were diagnosed according to the 2016 WHO criteria. Receiver operating characteristic curves were performed to assess the efficacy of perfusion parameters for grading. Qualitatively, all gliomas were divided into high- and low-perfusion groups. The crosstabs chi-square test of independence was performed to calculate contingency coefficient (C) and Cramer V coefficient to assess the correlation between perfusion and IDH1 genotypes and 1p/19q status of gliomas. The rmaxCBF showed the best diagnostic efficacy; meanwhile, rmeanCBF had the best specificity for grade discrimination. In astrocytoma, there was a mild correlation between IDH1 genotypes and tumor perfusion with the Cramer's V coefficient of 0.378. There was no significant association between 1p/19q codeletion and perfusion in grade II and III gliomas.

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“…Moreover, arterial spin labeling is not affected by the blood–brain barrier, and truly reflects the degree of perfusion. Arterial spin labeling can be applied repeatedly in children and restless patients [30] and assesses cerebral blood flow, which represents blood flow in a specific organ per unit. Tumor angiogenesis usually occurs during tumor progression from low to high grade and is characterized by increased blood flow.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of arterial spin labeling for preoperative grading of glioma

Wang

et al. 2018

Bioscience Reports

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There were obvious differences in biological behavior and prognosis between low- and high-grade gliomas, it is of great importance for clinicians to make a right judgement for preoperative grading. We conducted a comprehensive meta-analysis to evaluate the clinical utility of arterial spin labeling for preoperative grading. We searched the PubMed, Embase, China National Knowledge Infrastructure, and Weipu electronic databases for articles published through 10 November 2017 and used ‘arterial spin-labeling’ or ‘ASL perfusion, grading’ or ‘differentiation, glioma’ or ‘glial tumor, diagnostic test’ as the search terms. A manual search of relevant original and review articles was performed to identify additional studies. The meta-analysis included nine studies. No obvious heterogeneity was found in the data in a fixed-effect model. The pooled sensitivity and specificity were 90% (95% confidence interval (CI): 0.84–0.94) and 91% (95% CI: 0.83–0.96), respectively, and the pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 10.40 (95% CI: 2.21–20.77) and 0.11 (95% CI: 0.07–0.18). The diagnostic odds ratio (DOR) was 92.47 (95% CI: 39.61–215.92). The diagnostic score was 4.53 (95% CI: 3.68–5.38). The area under the curve (AUC) was 0.94 (95% CI: 0.91–0.96). Subgroup analyses did not change the pooled results. No publication bias was found (P=0.102). The normalized maximal tumor blood flow/normal white matter ratio obtained with the arterial spin labeling technique was relatively accurate for distinguishing high/low-grade glioma. As a non-invasive procedure with favorable repeatability, this index may be useful for clinical diagnostics.

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Perfusion imaging of brain gliomas using arterial spin labeling: correlation with histopathological vascular density in MRI-guided biopsies

Abstract: ASL can be a useful noninvasive perfusion MR method for quantitative evaluation of the MVD of brain gliomas.

Cited by 27 publications

References 35 publications

3D‐ASL perfusion correlates with VEGF expression and overall survival in glioma patients: Comparison of quantitative perfusion and pathology on accurate spatial location‐matched basis

3D‐ASL perfusion correlates with VEGF expression and overall survival in glioma patients: Comparison of quantitative perfusion and pathology on accurate spatial location‐matched basis

Arterial Spin Labeling for Glioma Grade Discrimination: Correlations with IDH1 Genotype and 1p/19q Status

Clinical utility of arterial spin labeling for preoperative grading of glioma

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