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Comparison of first-pass and second-bolus dynamic susceptibility perfusion MRI in brain tumors

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Medical University of South Carolina, 169 Ashley Avenue, P.O. Box 250322, Charleston, SC, 29425, USA

    M. Vittoria Spampinato, Nada Besenski & Zoran Rumboldt

  2. Medical School of South Carolina, Charleston, SC, USA

    Caroline Wooten & Margaret Dorlon

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  1. M. Vittoria Spampinato
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  2. Caroline Wooten
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  3. Margaret Dorlon
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  4. Nada Besenski
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Correspondence to M. Vittoria Spampinato.

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Spampinato, M.V., Wooten, C., Dorlon, M. et al. Comparison of first-pass and second-bolus dynamic susceptibility perfusion MRI in brain tumors. Neuroradiology 48, 867–874 (2006). https://doi.org/10.1007/s00234-006-0134-8

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  • DOI: https://doi.org/10.1007/s00234-006-0134-8

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