Gliomas, the most common primary brain neoplasms in adults, are very heterogeneous tumors. High-grade gliomas can be highly invasive and extremely vascular tumors. ⁽¹⁾

Glioma grading is currently based on the histopathologic assessment of the tumor, which is achieved by stereotactic brain biopsy or cytoreductive surgery; and there are inherent limitations with these techniques and their interpretation. ⁽¹⁾

Therapeutic approaches, response to therapy, and prognosis depend on accurate grading, and thus finding the part of the tumor with the highest grade to be biopsied is critical. ⁽¹⁾

The aim of this study was to evaluate role of CT perfusion in differentiation   between low grade and high grade glioma

Methods: This is study was conducted on 32 patients from 2012 to 2013.All patients were examined by CT perfusion

The patients were subjected to surgery and pathological analysis, then correlation between CT results and pathological analysis was done.

Results: In our study mean CBV for high and low grade glioma was 11.5ml/100gm and 0.36ml/100gm respectively with statistically significant value between two groups (P value= .037), the cut of value in was 2.9 ml /100gm with sensitivity 91% and specificity 100%.The CBF for high grade and low grade glioma was 168.6 ml/100gm/min and 13.3 ml/100gm/min respectively with statistically significant difference between two groups (P=.023). Cut of value was 38.8ml/100gm/min for CBF with sensitivity 91% and specificity 100% and for men PS in low and high grade glioma was 0.25 and 13.9 respectively with statistically significant difference (P value =.005) , the cut of value was 2 ml/100gm/min with sensitivity 91% and specificity 100% , for mean MTT for high and low grade glioma 4.6and 7.08 respectively with no statistically significant difference (P value =0.137) .

Conclusion: CT perfusion is a valuable method in differentiation between low and high grade glioma, it has the advantage of wider availability, faster scan time and lower cost compared to MR perfusion.

Keywords: CT perfusion. Low grade glioma. High grade glioma. 

1.      Jain R. Perfusion CT imaging of brain tumors: An overview. AJNR2011; 32: 1570-7.

2.      Jain R et al.Quantitative Estimation of Permeability Surface-Area Product in Astroglial Brain Tumors Using Perfusion CT and Correlation with Histopathologic Grade. AJNR 2008;29:694-700.

3.      Ahmed KA, Abd Elhameed AM: Perfusion CT cerebral blood volume and permeability surface in low and high grades of brain glioma .The Egyptian Journal of Radiology and Nuclear medicine 2012;43(3):449-58.

4.      EllikaSK et al. Role of Perfusion CT in Glioma Grading and Comparison with Conventional MR Imaging Features. AJNR 2007; 28: 1981-7.

Amal S Ismail

Department of Radio-Diagnosis, Faculty of Medicine, Alexandrian University, Egypt