High-Resolution Contrast-Enhanced, Susceptibility-Weighted MR Imaging at 3T in Patients with Brain Tumors: Correlation with Positron-Emission Tomography and Histopathologic Findings

K. Pinker; I.M. Noebauer-Huhmann; I. Stavrou; R. Hoeftberger; P. Szomolanyi; G. Karanikas; M. Weber; A. Stadlbauer; E. Knosp; K. Friedrich; S. Trattnig

doi:10.3174/ajnr.A0540

Article Figures & Data

Figures

Tables

Download figure
Open in new tab
Download powerpoint
Fig 1.
A 36-year-old male patient with right temporomesial glioblastoma WHO IV.
A, Axial 3T HR-CE-SW-MR images demonstrated a brain lesion with high frequency of SusE.
B, Axial 3T HR-CE-SW-MR images demonstrated a brain lesion with marked CE in HR-SW sequence.
C, Axial 3T HR-CE-SW-MR images demonstrated a brain lesion with marked CE in T1-weighted SE sequence.
D, FDG/MET-PET showed hypermetabolism temporal right (yellow arrow).
E and F, The lesion was determined by histopathology (H&E staining, ×200) as a glioblastoma WHO IV.
A and B, Intralesional SusE (yellow arrow) could be correlated to conglomerates of vessel proliferations (black arrows in D and E).
Download figure
Open in new tab
Download powerpoint
Fig 2.
A 40-year-old male patient with an oligoastrocytoma WHO II frontotemporal left.
A and B, Axial 3T HR-CE-SW-MR images depicted no SusE (A), as well as no significant contrast enhancement of the lesion in T1-weighted SusE and HR-SW images (B).
C, FDG/MET-PET showed a hypometabolism frontotemporal right (yellow arrow).
D, Histopathology (H&E staining, ×200) demonstrated no formations of SusE conglomerates.
Download figure
Open in new tab
Download powerpoint
Fig 3.
A 65-year-old male patient with glioblastoma multiforme (WHO IV).
A and B, Axial 3T HR-CE-SW-MR imaging demonstrated medium frequency of intralesional SusE refined to the medial part of the lesion and formation of SusE conglomerates (A) and marked peripheral contrast enhancement (B).

Tables

Figures

View popup

Table 1:

MR imaging and histopathologic findings

N	Lesions, n	Biopsy, n	SusE		CE	Histopathology
N	Lesions, n	Biopsy, n	Frequency	Conglomerates	CE	Tumor Grade	Diagnosis
1	1	1	3	1	3	High	Glioblastoma IV
2	1	1	3	1	3	High	Ependymoma II
2	2	2	3	1	3	High	Ependymoma II
3	1	1	3	1	3	High	Glioblastoma IV
3	2	1	3	1	3	High	Glioblastoma IV
3	3	1	3	1	3	High	Glioblastoma IV
4	1	1	2	1	1	High	Oligodendroglioma III
5	1	1	1	0	0	Low	Astrocytoma II
6	1	1	1	0	0	Intermediate	Astrocytoma II-III
7	1	1	2	1	0	High	Oligoastrocytoma III
8	1	1	3	1	3	High	Glioblastoma IV
9	1	1	3	1	3	High	Glioblastoma IV
10	1	1	3	1	3	High	Glioblastoma IV
11	1	1	1	0	1	High	Glioblastoma IV
12	1	1	1	0	0	Low	Oligoastrocytoma II
13	1	1	3	1	3	High	Glioblastoma IV
14	1	1	3	1	2	High	Glioblastoma IV
15	1	1	3	1	3	High	Glioblastoma IV
15	1	2	3	1	3	High	Glioblastoma IV
15	1	3	3	1	3	High	Glioblastoma IV
15	1	4	3	1	3	High	Glioblastoma IV
16	1	1	1	0	0	High	Astrocytoma III
17	1	1	2	1	3	High	Glioblastoma IV
17	2	2	2	1	3	High	Glioblastoma IV
18	1	1	3	1	3	High	Glioblastoma IV

Note:—SusE indicates susceptibility effects. Frequency of SusE: low = 1; medium = 2; high = 3. Formations of conglomerates of intralesional SusE: no = 0; yes = 1. Contrast enhancement: no = 0; minimal = 1; moderate = 2, marked = 3.

View popup

Table 2:

Cross-tabulation of histopathologic tumor grade and frequency of intralesional SusE and SusE conglomerates

Histopathologic Tumor Grade	Frequency of SusE, n (%)			Conglomerates, n (%)	Total, n (%)
Histopathologic Tumor Grade	Low	Medium	High	Conglomerates, n (%)	Total, n (%)
Low count	2 (8)	0	0	0	2 (8)
Intermediate count	1 (4)	0	0	0	1 (4)
High count	2 (8)	4 (16)	16 (64)	20 (80)	22 (88)
Total count	5 (20)	4 (16)	16 (64)	20 (80)	25 (100)

Note:—SusE indicates susceptibility effects. Frequency and formation of conglomerates of intralesional SusE showed good correlation with histopathologic tumor grade. A medium- or high-frequency intralesional SusE or formation of conglomerates was found in 90% of high-grade lesions.

View popup

Table 3:

Cross-tabulation of PET tumor grade and frequency of intralesional SusE and SusE conglomerates

PET Tumor Grade	Frequency of SusE, n (%)			Conglomerates, n (%)	Total, n (%)
PET Tumor Grade	Low	Medium	High	Conglomerates, n (%)	Total, n (%)
Low count	3 (25)	0	0	0	3 (25)
Intermediate count	0	1 (8.33)	0	1 (8.33)	1 (8.33)
High count	1 (8.33)	0	7 (58.33)	7 (58.33)	8 (66.67)
Total	4 (33.33)	1 (8.33)	7 (58.33)	8 (66.67)	12 (100)

Note:—SusE indicates susceptibility effects; PET, positron-emission tomography. Frequency of intralesional SusE, as well as formation of conglomerates correlated directly with tumor grade as determined by PET.