High microvascular blood volume is associated with high glucose uptake andtumor angiogenesis in human gliomas

The purpose of this investigation was to elucidate the association between microvascular blood volume and glucose uptake and to link these measures wi th tumor angiogenesis. We demonstrate a regionally specific correlation bet ween tumor relative microvascular blood volume (CBV), determined ill vivo w ith functional magnetic resonance imaging techniques, and tumor glucose upt ake determined with fluorodeoxyglucose positron emission tomography, Region s of maximum glucose uptake were well matched with maximum CBV across all p atients (n = 21; r = 0.572; P = 0.023). High-grade gliomas showed significa ntly elevated CBV and glucose uptake compared with low-grade gliomas, (P = 0.009 and 0.008, respectively). Correlations between CBV and glucose uptake were then determined on a voxel-by-voxel basis within each patient's gliom a, Correlation indices varied widely, but in 16 of 21 cases of human glioma , CBV and glucose uptake were correlated (I > 0.150). These measures were w ell correlated in all cases when comparing healthy brain tissue in these sa me patients. Tumor vascularity, as determined immunohistochemically and mor phometrically on clinical samples, revealed statistically significant relat ionships with functional imaging characteristics in vivo. Regional heteroge neities in glucose uptake were wed matched with functional magnetic resonan ce imaging CBV maps. Our findings support the concept that there is an asso ciation of microvascular density and tumor energy metabolism in most human gliomas. In addition, the findings are likely to have important clinical ap plications in the initial evaluation, treatment, and longitudinal monitorin g of patients with malignant gliomas.