Comparison of first-pass and second-bolus dynamic susceptibility perfusion MRI in brain tumors
- 183 Downloads
Our goal was to evaluate whether the T1 shortening effect caused by contrast leakage into brain tumors, a well-known confounding effect in the quantification of relative cerebral blood volume (rCBV) measurements, may be corrected by the administration of a predose of gadolinium-DTPA.
As part of their presurgical imaging protocol, 25 patients with primary brain tumors underwent two consecutive dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MR studies. Intratumoral rCBV measurements and normalized rCBV values obtained during the first-pass and second-bolus studies were compared (Wilcoxon signed-ranks test). The frequency of relatively increased rCBV ratios on the second-bolus study was compared between enhancing and non-enhancing neoplasms (Fisher’s exact test). Postprocessing perfusion studies were evaluated for image quality on a scale of 0–3 (Wilcoxon signed-ranks test). Four studies were excluded due to unacceptable image quality.
Mean normalized rCBVs were 9.04 (SD 4.64) for the first-pass and 7.99 (SD 3.84) for the second-bolus study. There was no statistically significant difference between the two perfusion studies in either intratumoral rCBV (P=0.237) or rCBV ratio (P=0.181). Five enhancing and four non-enhancing tumors showed a relative increase in rCBV ratio on the second-bolus study, without a significant difference between the groups. Image quality was not significantly different between perfusion studies.
Our results did not demonstrate a significant difference between first-pass and second-bolus rCBV measurements in DSC perfusion MR imaging. The administration of a predose of gadolinium-DTPA does not appear to be an efficient way of compensating for the underestimation of intratumoral rCBV values due to the T1 shortening effect.
KeywordsMagnetic resonance imaging Brain neoplasm Gadolinium DTPA Perfusion Dynamic susceptibility
Conflict of interest statement
We declare that we have no conflict of interest.
- 15.Lev MH, Ozsunar Y, Henson JW, et al (2004) Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol 25:214–221PubMedGoogle Scholar