ROLE OF CT PERFUSION IN EVALUATION OF BRAIN TUMORS AND DIFFERENTIATION OF BENIGN AND MALIGNANT LESIONS

Objective: To evaluate the role of computed tomography perfusion (CTP) in differentiating benign and malignant brain tumors in a cohort of 30 patients at GMC Nagpur. Methods: Thirty patients with radiologically suspected brain tumors underwent conventional CT followed by perfusion CT between January 2024 and June 2025. Perfusion parameters-cerebral blood volume (CBV), cerebral blood ow (CBF), mean transit time (MTT), time-to-peak (TTP), and permeability surface area product (PS)-were measured. Relative values (rCBV, rCBF) were calculated with respect to contralateral normal white matter. Histopathological examination was used as the reference standard. Results: Among the 30 patients, 18 were diagnosed with malignant tumors (high-grade gliomas, metastases, PCNSL) and 12 with benign tumors (meningiomas, schwannomas, pilocytic astrocytomas). Malignant tumors demonstrated signicantly higher rCBV (2.7 ± 0.6) and rCBF (2.3 ± 0.5) than benign tumors (rCBV 1.3 ± 0.4; rCBF 1.1 ± 0.3, p<0.001). PS was markedly elevated in malignant tumors (1.9 ± 0.5) compared to benign (0.8 ± 0.2). ROC analysis showed rCBV >2 as an optimal cut-off to differentiate malignant from benign tumors (sensitivity 85%, specicity 90%). Conclusion: CT perfusion is a valuable adjunct to conventional imaging, enabling functional assessment of tumor vascularity and reliable differentiation between benign and malignant brain tumors.