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Cerebral Blood Volume Measurements and Proton MR Spectroscopy in Grading of Oligodendroglial Tumors

M. Vittoria Spampinato1,2, J. Keith Smith1, Lester Kwock1, Matthew Ewend3, John D. Grimme1, Daniel L. A. Camacho1 and Mauricio Castillo1

1 Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.
2 Present address: Department of Radiology, Medical University of South Carolina, 169 Ashley Ave., PO Box 250322, Charleston, SC 29425.
3 Division of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.


Figure 1
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  		Fig. 1 —Scatterplot of relative cerebral blood volume (rCBV) ratios for each tumor shows significant difference between low-grade and high-grade oligodendroglial tumors (p < 0.05).

 

Figure 2
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  		Fig. 2A —44-year-old man with low-grade oligoastrocytoma. T1-weighted image obtained after gadolinium administration shows nonenhancing left temporal mass (arrows) involving superior cerebellar and perimesencephalic cistern.

 

Figure 3
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  		Fig. 2B —44-year-old man with low-grade oligoastrocytoma. T2-weighted image corresponding to A.

 

Figure 4
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  		Fig. 2C —44-year-old man with low-grade oligoastrocytoma. Relative cerebral blood volume map shows low tumoral vascularity.

 

Figure 5
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  		Fig. 2D —44-year-old man with low-grade oligoastrocytoma. MR spectra obtained with long TE (135 milliseconds) show mild elevation of choline (Cho) compared with creatine (Cr). NAA = N-acetyl aspartate.

 

Figure 6
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  		Fig. 3A —64-year-old man with anaplastic oligodendroglioma. T1-weighted image obtained after gadolinium administration shows right frontal cortex-based mass (arrow).

 

Figure 7
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  		Fig. 3B —64-year-old man with anaplastic oligodendroglioma. FLAIR image corresponding to A shows right frontal cortex-based mass (arrow).

 

Figure 8
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  		Fig. 3C —64-year-old man with anaplastic oligodendroglioma. Relative cerebral blood volume map shows elevated vascularization of tumor.

 

Figure 9
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  		Fig. 3D —64-year-old man with anaplastic oligodendroglioma. MR spectra obtained at long TE (135 milliseconds) show significant elevation of choline (Cho) compared with creatine (Cr2) and depressed N-acetyl aspartate (NAA) level.

 

Figure 10
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  		Fig. 4 —Scatterplot of intratumoral choline-to-creatine ratio (Cho/Cr) shows significant difference between low-grade and high-grade oligodendroglial tumors (p < 0.05).

 

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