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The study group consisted of 253 patients, aged 7\u201378\u00a0years with supratentorial gliomas (65 low-grade gliomas (LGG), 188 high-grade gliomas (HGG)). We used 3D pCASL-perfusion for each patient in order to calculate the tumor blood flow (TBF). We obtained maximal tumor blood flow (maxTBF) in small regions of interest (30\u2009\u00b1\u200910 mm<jats:sup>2<\/jats:sup>) and then normalized absolute maximum tumor blood flow (nTBF) to that of the contralateral normal-appearing white matter of the centrum semiovale. MaxTBF and nTBF values significantly differed between HGG and LGG groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), as well as between patient groups separated by the grades (grade II vs. grade III) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Moreover, we performed ROC-analysis which demonstrated high sensitivity and specificity in differentiating between HGG and LGG. We found significant differences for maxTBF and nTBF between grade III and IV gliomas, however, ROC-analysis showed low sensitivity and specificity. We did not observe a significant difference in TBF for astrocytomas and oligodendrogliomas. Our study demonstrates that 3D pCASL-perfusion as an effective diagnostic tool for preoperative differentiation of glioma grades.<\/jats:p>","DOI":"10.1038\/s41598-022-05992-4","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T11:04:34Z","timestamp":1644318274000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["3D pCASL-perfusion in preoperative assessment of brain gliomas in large cohort of patients"],"prefix":"10.1038","volume":"12","author":[{"given":"A. I.","family":"Batalov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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