• Anna Luisa Di Stefano, Niels Bergsland, Giulia Berzero, Lisa Farina, Elisa Rognone, Matteo Gastaldi, Domenico Aquino, Alessandro Frati, Francesco Tomasello, Mauro Ceroni, Enrico Marchioni, and Stefano Bastianello.
• Neuro-Oncology Unit, C. Mondino National Neurological Institute, 27100 Pavia, Italy ; Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
• Biomed Res Int. 2014 Jan 1; 2014: 154350.

AbstractTumoral neoangiogenesis characterizes high grade gliomas. Relative Cerebral Blood Volume (rCBV), calculated with Dynamic Susceptibility Contrast (DSC) Perfusion-Weighted Imaging (PWI), allows for the estimation of vascular density over the tumor bed. The aim of the study was to characterize putative tumoral neoangiogenesis via the study of maximal rCBV with a Region of Interest (ROI) approach in three tumor areas-the contrast-enhancing area, the nonenhancing tumor, and the high perfusion area on CBV map-in patients affected by contrast-enhancing glioma (grades III and IV). Twenty-one patients were included: 15 were affected by grade IV and 6 by grade III glioma. Maximal rCBV values for each patient were averaged according to glioma grade. Although rCBV from contrast-enhancement and from nonenhancing tumor areas was higher in grade IV glioma than in grade III (5.58 and 2.68; 3.01 and 2.2, resp.), the differences were not significant. Instead, rCBV recorded in the high perfusion area on CBV map, independently of tumor compartment, was significantly higher in grade IV glioma than in grade III (7.51 versus 3.78, P = 0.036). In conclusion, neoangiogenesis encompasses different tumor compartments and CBV maps appear capable of best characterizing the degree of neovascularization. Facing contrast-enhancing brain tumors, areas of high perfusion on CBV maps should be considered as the reference areas to be targeted for glioma grading.

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