Comparison of dynamic contrast-enhanced MRI with WHO tumor grading for gliomas

Assessment of vascular proliferation as an important grading criterion has been employed in both the histologic and the radiologic characterization of gliomas with encouraging results. Perfusion in gliomas can be measured by dynamic contrast-enhanced magnetic resonance imaging (dMRI). The goal of th is study was to develop a model for simultaneously quantifying the fraction al volumes of different tissue compartments of gliomas by dMRI. A modified method for evaluating dynamic contrast-enhanced MR images is presented whic h simultaneously determines the fractional vascular, interstitial, and cell ular volumes of gliomas. This method differs from techniques used in other studies in that it is based on a three-compartment model: a single blood co mpartment and two interstitial ones. The fractional volume maps are compare d with the WHO glioma grading. The results show the method to be feasible. Using cerebral blood volume (CBV), dMRI grading showed a correspondence wit h WHO grading in 83 % of the cases (20/24 gliomas WHO grades II-IV). The us e of interstitial volume maps can also be helpful, for instance, in differe ntiating gliomas from other brain tumors. As a supplement to conventional M RI, dynamic MR techniques thus provide a useful tool for improving in vivo glioma characterization.