ABSTRACT
Objective: To determine the diagnostic accuracy of perfusion computed tomography [PCT] in the grading of cerebral glioma
Study Design: Cross-sectional analytical study
Place and Duration of Study: Department of Radiology, Allied Hospital, Faisalabad, from January to June 2014
Methodology: All the patients with untreated glioma had an initial non-contrast head CT and then PCT using 128 multidetector CT scanner. Perfusion maps of permeability surface [PS] and cerebral blood volume [CBV] were generated and measured. As control, a second volume of interest was placed in the contralateral healthy cortex. PCT parameters were compared with World Health Organization [WHO] glioma grades
Results: Fifty patients of 30 - 70 years of age of both genders [mean 45.13 +/- 5.54], 31 [62%] males and 19 [38%] females were studied
These patients were classified as low-grade glioma group [22 patients] and high-grade glioma group [28 patients]. PS showed the sensitivity of 95.45%, specificity of 92.86% and diagnostic accuracy of 94% in differentiating the low-grade and high-grade glioma by using a cut-off value of 3.6 ml/100 g/minute. By using a cut-off value of CBV of 2.08 [ml/100 g] among low-grade and high-grade glioma group, CBV showed the sensitivity of 77.3%, specificity of 89.3%, and diagnostic accuracy of 84%
Conclusion: The derived parameters [PS and CBV] correlate well with tumor histopathology, differentiating low-grade from high-grade gliomas. PS showed better accuracy for glioma grading