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IntroductIon Gliomas are the most common primary brain tumors. Grading gliomas is of significant clinical importance because treatment plans vary between high‐ and low‐grade gliomas. Histopathologic grades of gliomas are closely related to microvasculature.[1] Magnetic resonance (MR) perfusion‐weighted imaging (PWI) is a technique to quantitatively evaluate tumor microenvironments by measuring cerebral blood volume (CBV).[2] Tissue similarity maps (TSM) based on relative cerebral blood volume (rCBV) are generated from a novel algorithm depending solely on the signal intensity time course without the need for a concentration‐time curve, which is required when using the conventional rCBV algorithm; therefore, TSM‐based rCBV (rCBVTSM) measurements are not influenced by certain factors, such as contrast‐to‐noise ratio and arterial input function (AIF).[3] However, applying TSM‐based rCBV measurement to grading gliomas has rarely been discussed. The main purpose of this study was to investigate the value of using TSM‐based rCBV measurement for grading gliomas.

Utility of Tissue Similarity Maps Based on Relative Cerebral Blood Volume for Grading Gliomas as Validated by Histological Results