Assessment of Diagnostic Accuracy of Perfusion MR Imaging in Primary and Metastatic Solitary Malignant Brain Tumors

PURPOSE: The purpose of this study was to estimate the diagnostic accuracy of relative cerebral blood volume (rCBV) measurement in preoperative grading and differentiation of solitary intra-axial malignant brain tumors. METHODS: Thirty-six low-grade glial tumors (LGGTs), 22 high-grade glial tumors (HGGTs), and 17 metastases (METs) were prospectively evaluated by MR imaging and standard dynamic susceptibility contrast-enhanced gradient echo, echoplanar imaging during first pass of a bolus injection of contrast material. Normalized rCBV values from tumoral (rCBVT) and peritumoral (rCBVP) areas were calculated by standard software and statistically tested independently. RESULTS: The mean differences of rCBVT and rCBVP values between LGGT (2.30 1.12 and 1.18 0.24) and HGGT (5.42 1.52 and 2.17 0.82) (P <.001); HGGTs and METs (3.21 0.98 and 0.97 0.09) (P <.001); and LGGTs and METs (P <.05 and P <.001, respectively) were significant. No clear cutoff value was present. A clear rCBVT cutoff value of 2.6 was detected for differentiation of low- (1.75 0.38; LGA) versus high-grade (4.78 0.99; HGA) astrocytomas when nonastrocytic glial tumors were excluded. The rCBVT values wer