Correlations between MR and endothelial hyperplasia in low-grade gliomas

Purpose: To investigate the capacity of multimodal MR to detect endothelial hyperplasia (EH), which has been linked to the aggressiveness of gliomas and which is so far only detected by biopsy, an invasive technique that prevents repeated measurements and early detection. Materials and Methods: A total of 26 patients with low-grade ghomas participated in the study. All underwent a histopathological analysis and a multimodal MR examination (spectroscopic, anatomic, diffusion, perfusion, and postcontrast imaging) Results: EH was present (EH+) in 15 patients and absent (EH-) in 11. No differences were observed between EH- and EH+ groups when comparing spectroscopic and diffusion parameters. Perfusion measurements, however, allowed us to distinguish EH+ from EH-: the relative regional cerebral blood flow (rCBF) was found equal to 3.23 +/- 2.05 for EH+ and 1.33 +/- 0.46 for EH- (P = 0.006). Conclusion: We have observed a strong correlation between the presence of EH and the increase of rCBF. Compared to conventional imaging, MR perfusion provides additional and complementary information that may be used for biopsy guidance, early detection of tumor aggressiveness, and noninvasive follow-ups.