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Repeatability of perfusion measurements in adult gliomas using pulsed and pseudo-continuous arterial spin labelling MRI

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Abstract

Objectives

To investigate the repeatability of perfusion measures in gliomas using pulsed- and pseudo-continuous-arterial spin labelling (PASL, PCASL) techniques, and evaluate different regions-of-interest (ROIs) for relative tumour blood flow (rTBF) normalisation.

Materials and methods

Repeatability of cerebral blood flow (CBF) was measured in the Contralateral Normal Appearing Hemisphere (CNAH) and in brain tumours (aTBF). rTBF was normalised using both large/small ROIs from the CNAH. Repeatability was evaluated with intra-class-correlation-coefficient (ICC), Within-Coefficient-of-Variation (WCoV) and Coefficient-of-Repeatability (CR).

Results

PASL and PCASL demonstrated high reliability (ICC > 0.9) for CNAH-CBF, aTBF and rTBF. PCASL demonstrated a more stable signal-to-noise ratio (SNR) with a lower WCoV of the SNR than that of PASL (10.9–42.5% vs. 12.3–29.2%). PASL and PCASL showed higher WCoV in aTBF and rTBF than in CNAH CBF in WM and GM but not in the caudate, and higher WCoV for rTBF than for aTBF when normalised using a small ROI (PASL 8.1% vs. 4.7%, PCASL 10.9% vs. 7.9%, respectively). The lowest CR was observed for rTBF normalised with a large ROI.

Discussion

PASL and PCASL showed similar repeatability for the assessment of perfusion parameters in patients with primary brain tumours as previous studies based on volunteers. Both methods displayed reasonable WCoV in the tumour area and CNAH. PCASL’s more stable SNR in small areas (caudate) is likely to be due to the longer post-labelling delays.

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Notes

  1. http://qibawiki.rsna.org/images/8/8c/FMRITechnicalPerformanceIndices041613.pdf, accessed on June 2018.

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Acknowledgements

AFA is funded by Taibah University from the Saudi Arabia Government. DLT was supported by the UCL Leonard Wolfson Experimental Neurology Centre (PR/ylr/18575), and the Wellcome Trust (Centre award 539208). EDV is funded by the Wellcome Engineering and Physical Sciences Research Council (EPSRC) Centre for Medical Engineering at Kings College London [WT 203148/Z/16/Z].SB is funded by National Institute for Health Research to UCLH Biomedical research centre (Grant: BRC399/NS/RB/101410). XG received funding by the European Union’s Horizon 2020 research and innovation programme, Grant/Award Number: 667510. This work received funding from the UCLH NIHR Biomedical Research Centre (DLT, SB, XG).

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Authors and Affiliations

  1. Department of Radiology Technology, Taibah University, Medina, Kingdom of Saudi Arabia

    Amirah Faisal Alsaedi

  2. Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK

    Amirah Faisal Alsaedi, David Lee Thomas, Sotirios Bisdas & Xavier Golay

  3. Leonard Wolfson Experimental Neurology Centre, UCL Queen Square Institute of Neurology, University College London, London, UK

    David Lee Thomas

  4. Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK

    Enrico De Vita

  5. Nuffield Department of Medicine, The Big Data Institute, University of Oxford, Oxford, UK

    Jasmina Panovska-Griffiths

  6. The Queen’s College, University of Oxford, Oxford, UK

    Jasmina Panovska-Griffiths

  7. Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK

    Enrico De Vita, Sotirios Bisdas & Xavier Golay

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Contributions

All authors contributed to the study conception and design. Study conception and design were fulfilled by XG, SB and AFA. Data collection were performed by DLT and EDV. Analysing and interpretation of the data were performed by AFA and JP-G. The first draft of the manuscript was written by AFA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Amirah Faisal Alsaedi.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article. XG is founder, shareholder and CEO of Gold Standard Phantoms, a UCL spinout company producing, among others, ASL phantoms.

Ethical approval

All participants provided signed informed consent, and the study was approved by the Queen Square Research Ethics committee (IRB).

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Alsaedi, A.F., Thomas, D.L., De Vita, E. et al. Repeatability of perfusion measurements in adult gliomas using pulsed and pseudo-continuous arterial spin labelling MRI. Magn Reson Mater Phy 35, 113–125 (2022). https://doi.org/10.1007/s10334-021-00975-4

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  • DOI: https://doi.org/10.1007/s10334-021-00975-4

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