A comparison of arterial spin labeling and dynamic susceptibility perfusion imaging for resection control in glioblastoma surgery

Abstract

Resection control using magnetic resonance imaging during neurosurgical interventions increases confidence regarding the extent of tumor removal already during the procedure. In addition to morphological imaging, functional information such as perfusion might become an important marker of the presence and extent of residual tumor mass. The aim of this study was to implement arterial spin labeling (ASL) perfusion imaging as a noninvasive alternative to dynamic susceptibility contrast (DSC) perfusion imaging in patients suffering from intra-axial tumors for resection control already during surgery. The study included 15 patients suffering from glioblastoma multiforme in whom perfusion imaging using DSC and ASL was performed before, during, and after surgery. The data obtained from intraoperative scanning were analyzed by two readers blinded to any clinical information, and the presence of residual tumor mass was evaluated using a ranking scale. Similarity of results was analyzed using the intraclass correlation coefficient and Pearson's correlation coefficient. The results show that intraoperative ASL is as reliable as DSC when performing intraoperative perfusion imaging. According to the results of this study, intraoperative imaging using ASL represents an attractive alternative to contrast agent-based perfusion imaging.

Application value between dynamic electrocardiogram and MSCT myocardial perfusion imaging in the diagnosis of myocardial ischemia in coronary heart disease

“…During systole, the capillary resistance under the intima will increase according to the degree of stenosis of the coronary arteries, and the blood volume of the capillaries will decrease, eventually leading to myocardial ischemia. This rule of change is used in the myocardial perfusion of MSCT, and the raw data obtained by coronary computed tomography angiography (CCTA) is used to evaluate the myocardial perfusion in the patient's systole to evaluate whether the patient has myocardial ischemia (14). There is no need for additional examinations for the patient, and the practice of CCTA diagnosis can simultaneously reflect the patient's hemodynamics and coronary artery stenosis, achieving a "one-stop" diagnosis (15).…”

Changes in computed tomography perfusion parameters and maximum contrast enhancement in patients having hydrocephalus with a ventriculoperitoneal shunt: a pilot study

“…Among perfusion MRI, ASL-MRI is fast, non-invasive, and can be performed repeatedly, and it does not require the use of gadolinium-containing contrast agents. It has several advantages as a safe test; however, a disadvantage of the test is that the diagnostic value remains incomplete (24). Perfusion MRI has several advantages; however, it is costly.…”

A Multi-Disciplinary Approach to Diagnosis and Treatment of Radionecrosis in Malignant Gliomas and Cerebral Metastases

“…In addition to delayed contrast extravasation MRI, quantitative sequences and arterial spin labelling (ASL) sequences are tools for the quantification of image data in radiology and thus pave the way for a more objective and reproducible non-invasive diagnosis [ 40 , 68 , 69 , 70 ]. ASL provides an absolute quantification of cerebral blood flow (but not CBV) and is not affected by capillary leakage, which leads to an underestimation of CBV and flow in perfusion sequences after gadolinium enhancement.…”

“…Furthermore, T1-, T2- and T2*/QSM-mapping and arterial spin labelling sequences are a tool for the quantification of image data in radiology and thus pave the way for a more objective and reproducible non-invasive diagnosis [ 40 , 68 , 69 , 70 , 72 ]. Importantly, T1- and T2-mapping and arterial spin labeling sequences do not require the application of contrast agents.…”