Article Figures & Data
Figures
- Fig 1.
Sample histogram. Percentile mean and SD measures are calculated from the top 50%, 25%, and 10% of the histogram curve. Skewness is zero if the data are distributed symmetrically around the mean, negative if the data are more spread out on the left of the mean, and positive if the data are more spread out on the right of the mean. Kurtosis, a measure of how “peaked” the histogram is, equals zero if the histogram is Gaussian, is positive if the histogram has a sharper peak, and is negative if it has a flatter top.
- Fig 2.
Low-grade glioma (grade II/IV) in left frontal lobe, T2-weighted (A) and contrast T1-weighted (B) images. The rCBVmax method uses 4 small ROIs targeted to foci of greatest perfusion on the rCBV map (C), with the maximal rCBV recorded from the subsequent perfusion curves (E). The signal intensity curves from each of the 5 ROIs are denoted as S1, S2, S3, S4, and S5, where S1 is the signal intensity curve for the ROI placed in normal brain and S2–S5 are the other ROIs placed in the tumoral tissue. These 5 signal intensity curves were obtained from a single section from the perfusion dataset. The rCBV histogram method uses a single ROI (D) that encompasses the maximal tumor diameter to generate the histogram curve (F), from which multiple metrics are derived.
- Fig 3.
High-grade glioma, glioblastoma multiforme (grade IV/IV) in frontal lobes spanning the corpus callosum. T2-weighted (A) and contrast T1-weighted (B) images are shown along with rCBVmax map (C) with ROIs targeted to avoid areas of radiologic necrosis to determine perfusion curves (E). rCBV histogram map (D) and histogram curve (F) are derived from the maximal tumor diameter regardless of heterogeneity.
Tables
Grade II III IV Median 1.14 ± 0.49 2.86 ± 1.13 2.72 ± 0.68 Mean 1.24 ± 0.47 2.90 ± 0.83 2.83 ± 0.68 SD 0.49 ± 0.32 2.31 ± 0.32 2.32 ± 0.29 Mean50 1.58 ± 0.58 3.65 ± 0.93 3.63 ± 0.86 SD50 0.46 ± 0.36 1.96 ± 0.31 1.94 ± 0.32 Mean25 1.85 ± 0.66 4.12 ± 0.82 4.12 ± 0.81 SD25 0.38 ± 0.33 1.80 ± 0.34 1.70 ± 0.33 Mean10 2.18 ± 0.76 4.55 ± 0.76 4.46 ± 0.71 SD10 0.35 ± 0.33 1.64 ± 0.42 1.54 ± 0.31 Skew 1.07 ± 0.83 0.46 ± 1.12 0.46 ± 0.78 Kurt 1.60 ± 3.04 0.59 ± 3.43 −0.26 ± 1.18 PH 0.22 ± 0.09 0.20 ± 0.18 0.19 ± 0.16 PP 1.10 ± 0.61 3.28 ± 1.85 3.34 ± 1.75 A1SD 0.66 ± 0.11 0.55 ± 0.20 0.55 ± 0.18 Note:—rCBV indicates relative cerebral blood volume; mean50, mean of the top 50% of the histogram; SD50, SD of the top 50%; mean25, mean of the top 25%; SD25, SD of the top 25%; mean10, mean of the top 10%; SD10, SD of the top 10%; skew, skewness; kurt, kurtosis; PH, peak height of the histogram; PP, peak position (ie, the mode); and A1SD, area under the histogram curve within 1 SD.
- Table 2:
rCBVT histogram metrics compared with rCBVmax and glioma grade, with correlation factors (r values) and Bonferroni-corrected significance <.005 (P values)
rCBVmax Grade r value P value r value P value Median 0.68880 <.0001 0.65849 <.0001 Mean 0.69444 <.0001 0.67710 <.0001 SD 0.66036 <.0001 0.71758 <.0001 Mean50 0.68600 <.0001 0.68166 <.0001 SD50 0.53042 <.0001 0.68441 <.0001 Mean25 0.66355 <.0001 0.68254 <.0001 SD25 0.53365 <.0001 0.66394 <.0001 Mean10 0.63072 <.0001 0.66342 <.0001 SD10 0.57135 <.0001 0.67416 <.0001 Skew −0.42895 <.0001 −0.26876 .0096 Kurt −0.29511 .0043 −0.34505 .0008 PH −0.11601 .2708 −0.21640 .0383 PP 0.63647 <.0001 0.62906 <.0001 A1SD −0.22241 .0331 −0.23301 .0254 Note:—rCBV indicates relative cerebral blood volume; mean50, mean of the top 50% of the histogram; SD50, SD of the top 50%; mean25, mean of the top 25%; SD25, SD of the top 25%; mean10, mean of the top 10%; SD10, SD of the top 10%; skew, skewness; kurt, kurtosis; PH, peak height of the histogram; PP, peak position (ie, the mode); and A1SD, area under the histogram curve within 1 SD. The highest correlations in each category are underlined; the metrics achieving significance are in bold.
- Table 3:
rCBVmax and rCBVT, thresholds with respective sensitivities, specificities, and p values
rCBVmax rCBVT High grade if metric is ≥1.75 ≥2.15 SD ≥1.7 SD25 ≥1.24 SD50 ≥1.35 Sensitivity (%) 98.4 95.1 95.1 95.1 95.1 Specificity (%) 67.7 80.7 100 96.8 96.8 P value (vs rCBVmax ≥ 1.75) <.001 <.001 <.001 P value (vs rCBVmax ≥ 2.15) .002 .004 .004 Note:—rCBV indicates relative cerebral blood volume; SD50, SD of the top 50%; SD25, SD of the top 25%.
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