Roh-Eul Yoo MD, Presenter: Nothing to Disclose

Chul-Ho Sohn MD, Abstract Co-Author: Nothing to Disclose

Seung Hong Choi MD, PhD, Abstract Co-Author: Nothing to Disclose

Ji-Hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Tae Jin Yoon, Abstract Co-Author: Nothing to Disclose

Ji Yeon Jang, Abstract Co-Author: Nothing to Disclose

Kee Hyun Chang MD, PhD, Abstract Co-Author: Nothing to Disclose

Moon Hee Han MD, Abstract Co-Author: Nothing to Disclose

Perfusion parameters evaluated by means of perfusion magnetic resonance (MR) imaging or dynamic computed tomography (CT) perfusion imaging have been suggested as key parameters in differentiation of primary cerebral lymphomas and high grade gliomas. Unlike perfusion MR imaging, arterial spin labeling (ASL) allows consecutive and quantitative assessment of the perfusion parameters. In addition, various molecular markers including O6-methylguanine-DNA methyltransferase (MGMT) and epidermal growth factor receptor (EGFR) have been studied in glioblastoma multiforme (GBM) for their association with the extent of tumor invasion and prognosis. The aim of the present study was to evaluate the usefulness of the pseudo-continuous ASL (pCASL) imaging in the differential diagnosis of primary cerebral lymphomas and high grade gliomas and to assess whether the genetic profiles in high grade gliomas could be predicted using the pCASL imaging.

Twenty two patients with histopathologically confirmed high grade gliomas (n=15) or lymphomas (n=7) underwent conventional MR imaging and pCASL imaging. For each tumor, cerebral blood flow (CBF) was measured in pCASL, at five ROIs, randomly selected within the area corresponding to the enhancing portion of the tumor. In terms of the average value of CBFs of the tumor, high grade gliomas were compared with lymphomas. In high grade gliomas, histopathologically confirmed genetic profiles were identified and were correlated with the average value of CBFs of the tumor.

Average values of CBFs of the high grade gliomas and lymphomas were 90.1 ± 42.3 and 29.7 ± 13.4 ml/100g/min, respectively, which resulted in statistical significance (P=0.0015). Among the histopathologically confirmed genetic profiles, significant positive correlation was found between EGFR amplification and the average value of CBF of high grade gliomas (r=0.6447, P=0.032).

CBF measurement on pCASL may facilitate differentiation of high grade gliomas and lymphomas. Furthermore, pCASL may serve as a noninvasive mean to predict EGFR amplification status, which is associated with the extent of tumor invasion and prognosis.  

We believe that ASL may merit further development as a noninvasive biomarker potentially useful in tumor differentiation and prediction of prognosis.

Yoo, R, Sohn, C, Choi, S, Kim, J, Yoon, T, Jang, J, Chang, K, Han, M, Cerebral Blood Flow from Arterial Spin Labeling Perfusion Magnetic Resonance Imaging: A Key Parameter in Distinguishing Primary Cerebral Lymphoma from High-Grade Glioma and a Biomarker for Genetic Profiles in High-Grade Glioma.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011265.html