Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma

Abstract

HighlightsDSC/ASL-MRI can be acquired in growing VS with sufficient image quality.In most patients DSC and ASL techniques provide similar qualitative scores.These techniques can be of importance in future decision-making.

Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles

“…Regarding size, DCE-MRI has the theoretical advantage of better spatial resolution and less susceptibility artifacts around bone–air interfaces (e.g., the mastoid bone) in comparison with DSC-MRI ( 8 , 15 , 16 , 17 , 18 ) . We were able to confirm this, showing that DCE-MRI allowed proper ROI placement in small intracanalicular VSs, obtaining similar values after placing several ROIs in contiguous locations and perfusion curves consistent with those obtained in larger VSs ( Figure 2 ).…”

“…It is important to recognize the clinical role PWI may play in the follow up of VS. Kleijwegt et al ( 16 ) used DSC-MRI to predict the growth of VS, and Li et al ( 36 ) used DCE-MRI to predict the response to bevacizumab in neurofibromatosis type 2-associated VS. Although those studies carry the promise of a change in the paradigm of VS management, they, like other studies, excluded small tumors and did not consider cystic status.…”

Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI

“…DSC‐MRI technique can provide physiologic information regarding tumor's microvasculature and vascular permeability, and CBV and CBF are the most commonly used parameters for brain tumor differentiation, tumor grading, and treatment response assessment 20–22 . However, this technique has not been often utilized for intracranial extra‐axial tumors 13,14 . Paragangliomas are hypervascular tumors with prominent vascular structures, and prior studies using dynamic contrast‐enhanced perfusion MRI (DCE‐MRI) showed that fractional plasma volume, which represents tumor's microvascularity, was higher in paragangliomas than in schwannomas 12,18 .…”

“…[20][21][22] However, this technique has not been often utilized for intracranial extra-axial tumors. 13,14 Paragangliomas are hypervascular tumors with prominent vascular structures, and prior studies using dynamic contrast-enhanced perfusion MRI (DCE-MRI) showed that fractional plasma volume, which represents tumor's microvascularity, was higher in paragangliomas than in schwannomas. 12,18 Our result suggests that CBV and CBF can also be promising parameters to differentiate paragangliomas and schwannomas.…”

“…Recently, diffusion-weighted imaging (DWI) and perfusion MRI have been utilized for tumor differentiation, gene mutation detection, and treatment monitoring by assessing internal microstructure and vascularity of the tumors. [11][12][13][14][15][16] Paragangliomas are known to be hypervascular tumors, while schwannomas show a relatively slow enhancement pattern compared to paragangliomas. 12 Also, there are differences in internal microstructure between the two tumors and even between sporadic and NF2-related schwannomas.…”