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Comparative Evaluation of 3-Dimensional Pseudocontinuous Arterial Spin Labeling With Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Human Glioma

Roy, Bhaswati PhD*; Awasthi, Rishi PhD; Bindal, Amit MCh; Sahoo, Prativa MSc§; Kumar, Rajan MS; Behari, Sanjay MCh; Ojha, Bal K. MCh; Husain, Nuzhat MD; Pandey, Chandra M. PhD#; Rathore, Ram K.S. PhD§; Gupta, Rakesh Kumar MD*

Journal of Computer Assisted Tomography: May/June 2013 - Volume 37 - Issue 3 - p 321–326
doi: 10.1097/RCT.0b013e318282d7e2
Neuroradiology

Introduction: The study was performed to compare dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) with 3-dimensional (3D) pseudocontinuous arterial spin labeling (PCASL) MRI in gliomas with an aim to see whether arterial spin labeling (ASL)–derived cerebral blood flow (CBF) values can be used as an alternative to DCE-MRI for its grading.

Materials and Methods: Sixty-four patients with glioma (37 male; mean age, 43 years; 38 high grade and 26 low grade) underwent 3D-PCASL and DCE-MRI. The DCE indices (relative cerebral blood volume, rCBV; relative CBF, rCBF; permeability, ktrans and kep; and leakage, ve) and ASL (absolute and rCBF) values were quantified from the tumors. Student independent t test was used to compare ASL and DCE-MRI indices. Pearson correlation was used to see correlation between DCE- and ASL-derived CBF values in tumor and normal parenchyma.

Results: On Student t test, neither ASL-derived absolute CBF (P = 0.78) nor rCBF (P = 0.12) values were found to be significantly different in 2 groups, whereas DCE indices except ve were significantly higher in high-grade gliomas. Arterial spin labeling–derived rCBF values weakly correlated with DCE-derived rCBF values, whereas these did not show correlation in normal grey (P = 0.12, r = 0.2) and white (P = 0.26, r = 0.14) matter regions.

Conclusions: Three-dimensional pseudocontinuous arterial spin labeling does not appear to be a reliable technique in the current form and may not be a suitable replacement for DCE in grading of glioma.

From the *Departments of Radiology & Imaging, Fortis Memorial Research Institute, Gurgaon; †Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; ‡Department of Neurosurgery, Chhatrapati Sahuji Maharaj Medical University, Lucknow; §Department of Mathematics and Statistics, Indian Institute of Technology, Kanpur; ∥Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; ¶Department of Pathology, Ram Manohar Lohia, Institute of Medical Sciences, Lucknow; and #Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Received for publication November 1, 2012; accepted December 12, 2012.

Reprints: Rakesh Kumar Gupta, MD, Department of Radiology & Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India 122002 (e-mail: rakeshree1@gmail.com).

Bhaswati Roy acknowledges the financial support from University Grant Commission, New Delhi, India; Rishi Awasthi acknowledges the financial support from Indian Council of Medical Research, New Delhi, India.

The authors have no funding or conflicts of interest to disclose.

© 2013 by Lippincott Williams & Wilkins