Role of Perfusion CT in Glioma Grading and Comparison with Conventional MR Imaging Features

Ellika, Shehanaz; Jain, Rajan; Patel, Suresh; Scarpace, Lisa; Schultz, Lonni; Rock, Jack; Mikkelsen, Tom

doi:10.3174/ajnr.a0688

Cited by 119 publications

(69 citation statements)

References 36 publications

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“…CT perfusion has not been studied extensively despite the ubiquity of CT scanners [16]. However, CT perfusion can help distinguish between high and low grade gliomas [7,[17][18][19] and between tumor recurrence and radiation necrosis [20,21]. Therefore, CT perfusion should be considered as a potentially valuable perfusion imaging modality in neuro-oncology.…”

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confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

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Patients with high-grade gliomas usually have heterogeneous response to surgery and chemoirradiation. The objectives of this study were (1) to evaluate serial changes in tumor volume and perfusion imaging parameters and (2) to determine the value of these data in predicting overall survival (OS). Twenty-nine patients with World Health Organization grades III and IV gliomas underwent magnetic resonance (MR) and computed tomography (CT) perfusion examinations before surgery, and 1, 3, 6, 9, and 12 months after radiotherapy. Serial measurements of tumor volumes and perfusion parameters were evaluated by receiver operating characteristic analysis, Cox proportional hazards regression, and Kaplan-Meier survival analysis to determine their values in predicting OS. Higher trends in blood flow (BF), blood volume (BV), and permeability-surface area product in the contrast-enhancing lesions (CEL) and the non-enhancing lesions (NEL) were found in patients with OS \ 18 months compared to those with OS C 18 months, and these values were significant at selected time points (P \ 0.05). Only CT perfusion parameters yielded sensitivities and specificities of C70 % in predicting 18 and 24 months OS. Pre-surgery BF in the NEL and BV in the CEL and NEL 3 months after radiotherapy had sensitivities and specificities [80 % in predicting 24 months OS in patients with grade IV gliomas. Our study indicated that CT perfusion parameters were predictive of survival and could be useful in assessing early response and in selecting adjuvant treatment to prolong survival if verified in a larger cohort of patients.

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confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

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“…In general, PCT of HGGs (grade III and IV) demonstrated higher BF, BV, and PS than low-grade gliomas (grade II) [11,[14][15][16][17][18][19][20][21][22]. Figs.…”

Section: Correlation With Histopathologic Markers and Tumor Gradementioning

confidence: 99%

Dynamic perfusion CT in brain tumors

Yeung

Yartsev

Fainardi

et al. 2015

European Journal of Radiology

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“…6,7 Ellika et al 6 were able to differentiate low-and high-grade gliomas with a high sensitivity (85.7%) and specificity (100%) by using PCT and a CBV normalized relative to a normal-appearing contralateral white matter threshold of 1.92. This relationship between CBV and histologic grade is intuitive because pathology studies show higher MVD in higher grade tumors.…”

Section: Relationship Between Glioma Grade and Pct Parametersmentioning

confidence: 99%

“…Traditionally, perfusion imaging of brain tumors has been performed with MR imaging, by using various perfusion imaging techniques and estimating tumor blood volume, blood flow, and permeability. [3][4][5] However, PCT, which has also been used recently for glioma grading, 6,7 provides a linear relationship between tissue attenuation and tissue concentration of a contrast agent, unlike perfusion MR imaging, and, hence, probably provides a more robust and less biased estimation of hemodynamic (tumor blood volume) and physiologic (tumor vascular leakiness) parameters. In view of the wider availability, faster scanning times, and low cost compared with MR perfusion, PCT is potentially well-suited to study brain tumors 6,7 and could potentially be useful as an easy tool for quantitative estimates of perfusion parameters and their use as imaging biomarkers.…”

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Perfusion CT Imaging of Brain Tumors: An Overview

Jain¹

2010

AJNR Am J Neuroradiol

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SUMMARY: Perfusion imaging of brain tumors has been performed by using various tracer and nontracer modalities and can provide additional physiologic and hemodynamic information, which is not available with routine morphologic imaging. Tumor vascular perfusion parameters obtained by using CT or MR perfusion have been used for tumor grading, prognosis, and treatment response in addition to differentiating treatment/radiation effects and non-neoplastic lesions from neoplasms. This article is an overview of the utility of PCT for assessment of brain tumors and describes the technique, its advantages, and limitations.

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Role of Perfusion CT in Glioma Grading and Comparison with Conventional MR Imaging Features

Cited by 119 publications

References 36 publications

Survival prediction in high-grade gliomas using CT perfusion imaging

Survival prediction in high-grade gliomas using CT perfusion imaging

Dynamic perfusion CT in brain tumors

Perfusion CT Imaging of Brain Tumors: An Overview

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