"Tumoral pseudoblush" identified within gliomas at high-spatial- resolution ultrahigh-field-strength gradient-echo MR imaging corresponds to microvascularity at stereotactic biopsy

Gregory A. Christoforidis, Ming Yang, Amir Abduljalil, Abhik R. Chaudhury, Herbert B. Newton, John M. McGregor, Clara R. Epstein, William T.C. Yuh, Sydeaka Watson, Pierre Marie L. Robitaille

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Purpose: To use directed biopsy sampling to determine whether microvascular assessment within gliomas, by means of ultrahigh- field-strength high-spatial-resolution gradient-echo (GRE) magnetic resonance (MR) imaging at 8 T, correlates with histopathologic assessment of microvascularity. Materials and Methods: The study was institutional review board approved and HIPAA compliant. Informed consent was obtained. Thirtyfive subjects with gliomas underwent 8-T and 80-cm MR imaging by using a GRE sequence (repetition time, 600-750 msec; echo time, 10 msec; in-plane resolution, 196 mm). Haphazardly arranged serpentine low-signal-intensity structures, often associated with areas of low signal intensity within the tumor bed ("tumoral pseudoblush") at MR imaging, were presumed to be related to tumoral microvascularity. Microvessel density (MVD) and microvessel size (MVS) ranked with a semiquantitative three-tier scale (high, medium, and low) relative to cortical penetrating veins were assessed from regions of interest identified at MR imaging and were compared with a similar assessment of stereotactic biopsy specimens by using Kendall tb. Tumor grade (high vs low) was compared with ultrahighfield- strength high-resolution GRE MR analysis by using Pearson χ2. Discrepancies between 8-T and histopathologic assessment were identified and analyzed. Results: Ultrahigh-field-strength high-resolution GRE MR imaging and histopathologic assessment concurred for MVS (P < .0001) and MVD (P < .0001). World Health Organization classification tumor grade was associated with number (P < .0005) and size (P < .0005) of foci of microvascularity within the tumor bed at 8-T MR imaging. Radiation-induced microvessel hyalinosis mimicked tumor microvascularity at 8-T MR imaging. Potential confounders could result from radiofrequency inhomogeneity and displaced normal microvasculature. Conclusion: Microvascularity identified as a tumoral pseudoblush at ultrahigh-field-strength high-resolution GRE MR imaging without contrast material shows promise as a marker for increased tumoral microvascularity.

Original languageEnglish (US)
Pages (from-to)210-217
Number of pages8
JournalRadiology
Volume264
Issue number1
DOIs
StatePublished - Jul 2012

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Christoforidis, G. A., Yang, M., Abduljalil, A., Chaudhury, A. R., Newton, H. B., McGregor, J. M., Epstein, C. R., Yuh, W. T. C., Watson, S., & Robitaille, P. M. L. (2012). "Tumoral pseudoblush" identified within gliomas at high-spatial- resolution ultrahigh-field-strength gradient-echo MR imaging corresponds to microvascularity at stereotactic biopsy. Radiology, 264(1), 210-217. https://doi.org/10.1148/radiol.12110799