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Perfusion MRI of brain tumours: a comparative study of pseudo-continuous arterial spin labelling and dynamic susceptibility contrast imaging

  • Diagnostic Neuroradiology
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Abstract

Introduction

The purpose of this study was to compare the non-invasive 3D pseudo-continuous arterial spin labelling (PC ASL) technique with the clinically established dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-MRI) for evaluation of brain tumours.

Methods

A prospective study of 28 patients with contrast-enhancing brain tumours was performed at 3 T using DSC-MRI and PC ASL with whole-brain coverage. The visual qualitative evaluation of signal enhancement in tumour was scored from 0 to 3 (0 = no signal enhancement compared with white matter, 3 = pronounced signal enhancement with equal or higher signal intensity than in grey matter/basal ganglia). The extent of susceptibility artefacts in the tumour was scored from 0 to 2 (0 = no susceptibility artefacts and 2 = extensive susceptibility artefacts (maximum diameter > 2 cm)). A quantitative analysis was performed with normalised tumour blood flow values (ASL nTBF, DSC nTBF): mean value for region of interest (ROI) in an area with maximum signal enhancement/the mean value for ROIs in cerebellum.

Results

There was no difference in total visual score for signal enhancement between PC ASL and DSC relative cerebral blood flow (p = 0.12). ASL had a lower susceptibility-artefact score than DSC-MRI (p = 0.03). There was good correlation between DSC nTBF and ASL nTBF values with a correlation coefficient of 0.82.

Conclusion

PC ASL is an alternative to DSC-MRI for the evaluation of perfusion in brain tumours. The method has fewer susceptibility artefacts than DSC-MRI and can be used in patients with renal failure because no contrast injection is needed.

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Acknowledgements

This study was supported in part by NIH grant, 5 R01 CA115745 (D.C. Alsop).

Conflict of interest statement

E. T. Fründ is employed at Aalborg Hospital, Department of Radiology with association to GE Healthcare—Applied Science Lab Europe. A. Shankaranarayanan is employed at GE Healthcare, Applied Science Lab, Menlo Park, California. D. C. Alsop is an inventor on several patents related to ASL and to the ASL sequence in this manuscript. This author receives research support from GE Healthcare and Merck & Co. and works as a paid consultant for Merck & Co.

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Authors and Affiliations

  1. Department of Radiology, Aalborg Hospital/Århus University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark

    Hanna Järnum, Elena G. Steffensen, Ernst-Torben Fründ, Carsten Wiberg Simonsen, Finn Taagehøj Jensen & Elna-Marie Larsson

  2. Department of Medical Radiation Physics, Lund University, Lund, Sweden

    Linda Knutsson

  3. GE Healthcare—Applied Science Lab Europe, Aalborg, Denmark

    Ernst-Torben Fründ

  4. Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital/Århus University Hospital, Aalborg, Denmark

    Søren Lundbye-Christensen

  5. GE Healthcare, Global Applied Science Lab, Menlo Park, CA, USA

    Ajit Shankaranarayanan

  6. Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    David C. Alsop

  7. Department of Radiology, Uppsala University Hospital, Uppsala, Sweden

    Elna-Marie Larsson

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  1. Hanna Järnum
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Correspondence to Hanna Järnum.

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Järnum, H., Steffensen, E.G., Knutsson, L. et al. Perfusion MRI of brain tumours: a comparative study of pseudo-continuous arterial spin labelling and dynamic susceptibility contrast imaging. Neuroradiology 52, 307–317 (2010). https://doi.org/10.1007/s00234-009-0616-6

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  • DOI: https://doi.org/10.1007/s00234-009-0616-6

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