PT  - JOURNAL ARTICLE
AU  - Zeng, Q.
AU  - Jiang, B.
AU  - Shi, F.
AU  - Ling, C.
AU  - Dong, F.
AU  - Zhang, J.
TI  - 3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in the Preoperative Evaluation of Gliomas
AID  - 10.3174/ajnr.A5299
DP  - 2017 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1876--1883
VI  - 38
IP  - 10
4099  - http://www.ajnr.org/content/38/10/1876.short
4100  - http://www.ajnr.org/content/38/10/1876.full
SO  - Am. J. Neuroradiol.2017 Oct 01; 38
AB  - BACKGROUND AND PURPOSE: Previous studies showed conflicting results concerning the value of CBF maps obtained from arterial spin-labeling MR imaging in grading gliomas. This study was performed to investigate the effectiveness of CBF maps derived from 3D pseudocontinuous arterial spin-labeling in preoperatively assessing the grade, cellular proliferation, and prognosis of gliomas.MATERIALS AND METHODS: Fifty-eight patients with pathologically confirmed gliomas underwent preoperative 3D pseudocontinuous arterial spin-labeling. The receiver operating characteristic curves for parameters to distinguish high-grade gliomas from low-grade gliomas were generated. Pearson correlation analysis was used to assess the correlation among parameters. Survival analysis was conducted with Cox regression.RESULTS: Both maximum CBF and maximum relative CBF were significantly higher in high-grade gliomas than in low-grade gliomas (P < .001). The areas under the curve for maximum CBF and maximum relative CBF in distinguishing high-grade gliomas from low-grade gliomas were 0.828 and 0.863, respectively. Both maximum CBF and maximum relative CBF had no correlation with the Ki-67 index in all subjects and had a moderate negative correlation with the Ki-67 index in glioblastomas (r = −0.475, −0.534, respectively). After adjustment for age, a higher maximum CBF (P = .008) and higher maximum relative CBF (P = .005) were associated with worse progression-free survival in gliomas, while a higher maximum relative CBF (P = .033) was associated with better overall survival in glioblastomas.CONCLUSIONS: 3D pseudocontinuous arterial spin-labeling–derived CBF maps are effective in preoperative evaluation of gliomas. Although gliomas with a higher blood flow are more malignant, glioblastomas with a lower blood flow are likely to be more aggressive.ASLarterial spin-labelingCASLcontinuous ASLGBMglioblastomaHGGhigh-grade gliomaHRhazard ratioKPSKarnofsky Performance ScaleLGGlow-grade gliomamaxmaximumOSoverall survivalpCASLpseudocontinuous ASLPFSprogression-free survivalROCreceiver operating characteristicWHOWorld Health Organization