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


CONCLUSIONS
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.
Department of Radiology, Aalborg Hospital/Arhus University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark. h.jarnum@rn.dk
Hanna
H
Järnum
Elena G
EG
Steffensen
Linda
L
Knutsson
Ernst-Torben
ET
Fründ
Carsten Wiberg
CW
Simonsen
Søren
S
Lundbye-Christensen
Ajit
A
Shankaranarayanan
David C
DC
Alsop
Finn Taagehøj
FT
Jensen
Elna-Marie
EM
Larsson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D001932:Brain Neoplasms / Q000098:blood supply / Q000473:pathology*; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology; D055420:Perfusion Imaging / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult