Dynamic contrast-enhanced derived cerebral blood volume correlates better with leak correction than with no correction for vascular endothelial growth factor, microvascular density, and grading of astrocytoma.

OBJECTIVE: To look for the impact of leak correction on correlation of perfusion indices with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in astrocytomas. METHODS: Dynamic contrast-enhanced magnetic resonance imaging was performed in 64 patients with varying grades of astrocytoma. Perfusion indices (ie, relative cerebral blood volume (rCBV) with and without leak correction, relative cerebral blood flow (rCBF), permeability (k(trans)), and leakage (v(e)) were quantified. MVD and VEGF-expressing cells were quantified from the excised tumor tissues and were correlated with perfusion metrics. RESULTS: Perfusion indices showed significant difference among the astrocytoma grades. The corrected rCBV correlated better with MVD and VEGF. The corrected rCBV correlated (r = 0.853, P = <0.001) strongly, whereas the uncorrected rCBV (r = 0.592, P = <0.001) and k(trans) (r = 0.498, P = 0.001) correlated moderately with tumor grade. The corrected rCBV discriminated 100% low-grade from high-grade astrocytoma, while uncorrected rCBV did this in 95.5% low-grade and 71.4% high-grade astrocytoma. CONCLUSIONS: Corrected rCBV better correlates with grade and is more accurate in discriminating low-grade from high-grade astrocytoma compared with uncorrected rCBV.

Relative cerebral blood volume is a measure of angiogenesis in brain tuberculoma.

OBJECTIVE: The aim of this study was to correlate the perfusion indices with magnetic resonance imaging-derived cellular and necrotic fraction of the tuberculoma and angiogenesis metrics on histopathology. METHODS: We performed dynamic contrast-enhanced magnetic resonance imaging in 13 excised brain tuberculoma patients. Microvascular density and vascular endothelial growth factor (VEGF)-expressing cells were quantified from the excised tuberculoma. The cellular and necrotic fractions of the tuberculomas were quantified on a postcontrast T1-weighted imaging. RESULTS: Relative cerebral blood volume of cellular portion significantly correlated with cellular fraction volume (r = 0.882, P < 0.001), microvascular density (r = 0.900, P < 0.001), and VEGF (r = 0.886, P < 0.001) of the 13 excised tuberculomas. Microvascular density also correlated significantly with VEGF (r = 0.919, P < 0.001). CONCLUSIONS: Relative cerebral blood volume is a measure of angiogenesis in the cellular fraction of the brain tuberculoma. This information may be of value in predicting the therapeutic response in future.