Brain tumor perfusion: comparison of dynamic contrast enhanced magnetic resonance imaging using T1, T2, and T2* contrast, pulsed arterial spin labeling, and H2(15)O positron emission tomography.
OBJECTIVE
Different techniques for measuring of perfusion are clinically available, but these are usually applied to healthy brain tissue.


METHODS
Five different techniques were used here in 12 patients with brain tumors to investigate the impact of tumor vascularization on the perfusion signal: three qualitative dynamic contrast-enhanced/susceptibility-contrast magnetic resonance imaging (DCE-MRI/DSC-MRI) techniques exploiting T(1), T(2), T(2)(*) contrast, and two quantitative techniques, pulsed arterial spin labeling (PASL) and H(2)(15)O positron emission tomography (H(2)(15)O-PET).


RESULTS
In a first approximation, a linear correlation was found between all five imaging modalities regarding the perfusion signal of both, normal brain tissue and tumor. The estimated values for tumor perfusion differed significantly between the techniques (1=methodical mean in arbitrary units): PASL: 0.83, H(2)(15)O-PET: 0.62, T(1)-DCE: 1.73, T(2)-DCE: 0.69, T(2)(*)-DSC: 0.89.


CONCLUSIONS
The tumor perfusion values, determined with different techniques are not comparable. The T(2)(*)-DSC, here applied with contrast agent presaturation of extravascular space, and PASL depict median perfusion most reliably.
Lüdemann
Lutz
L
Department of Radiation Medicine, Universitätsklinikum Charité, Campus Virchow-Klinikum, Berlin, Germany. lutz.luedemann@charite.de
Warmuth
Carsten
C
Plotkin
Michail
M
Förschler
Annette
A
Gutberlet
Matthias
M
Wust
Peter
P
Amthauer
Holger
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply / Q000175:diagnosis*; D003287:Contrast Media; D019786:Gadolinium DTPA; D005910:Glioma / Q000098:blood supply / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D010103:Oxygen Isotopes; D055420:Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D014867:Water; D055815:Young Adult
D003287:Contrast Media; D010103:Oxygen Isotopes; D019275:Radiopharmaceuticals; D013113:Spin Labels; D014867:Water; D019786:Gadolinium DTPA