A Comparative Study of Perfusion Measurement in Brain Tumours at 3 Tesla MR: Arterial Spin Labeling versus Dynamic Susceptibility Contrast-Enhanced MRI

Abstract

Purpose: To prove the feasibility of arterial spin labeling (ASL) to explore brain tumors by comparing dynamic susceptibility contrast-enhanced MRI to ASL at 3T MR. Materials and Methods: Twenty-seven patients were included presenting 9 gliomas, 10 metastases and 8 meningiomas. All were explored by a pseudo-continuous ASL and dynamic susceptibility contrast-enhanced T2* perfusion sequence. Two neuroradiologists analyzed the cerebral blood flow (CBF) maps to assess feasibility, examination quality and quantitative comparison. The Spearman nonparametric correlation test and the Bland-Altman graphic test were used to analyze our quantitative results. Results: 92% of ASL CBF maps were informative. ASL detected all lesions as well as dynamic susceptibility contrast-enhanced MRI. Both sequences provide relative quantitative CBF values closely correlated. Conclusion: On a 3T MR unit, ASL is a good alternative to dynamic susceptibility contrast-enhanced MRI when contrast medium is contraindicated or intravenous injection is not possible. Its results on relative CBF parameters are similar to contrast-injected perfusion.

Arterial Spin Labeling Perfusion of the Brain: Emerging Clinical Applications

“…Initial reports demonstrated that ASL and DSC show largely concordant results in terms of identifying this tumor, and distinguishing it from contrast-enhancing mimics (89)(90)(91)(92). Higher CBF in GBM correlates with genetic markers (such as epidermal growth factor receptor) and is associated with shorter progression free survival time (93).…”

MR Imaging–Based Analysis of Glioblastoma Multiforme: Estimation ofIDH1Mutation Status

“…For each tumor, mean absolute (aTBF) and relative tumor blood flow (rTBF) were measured in each ROI (Fig 1A). [35][36][37][38] Interrater agreement was evaluated by the To determine absolute tumor blood flow, we placed the ROI in the enhancing lesion (A, black circle). Relative TBF was obtained by normalizing the aTBF by a blood flow measurement from the reference region (white circle).…”

Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery

“…20,27 In terms of detection of gliomas and metastases, ASL and DSC-MR imaging also showed similar diagnostic yields. 28,29 However, ASL has the advantages of better signal-to-noise ratio, fewer distortion effects secondary to hemorrhage, and the potential for quantification. 17 More definitive studies comparing the 2 modalities will be needed in the patient population with postradiation metastasis.…”