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Neuroradiology |
1 From the Department of Neuroradiology, Charité Medical School, Humboldt University of Berlin, Schumannstrasse 20-21, D-10098 Berlin, Germany (C.W., C.Z.); and Advanced MRI Technologies, Sebastopol, Calif (M.G.). Received April 11, 2002; revision requested June 17; final revision received November 21; accepted December 19. C.W. supported by the German Research Foundation (Deutsche Forschungsgemeinschaft). Address correspondence to C.Z. (e-mail: claus.zimmer@charite.de).
PURPOSE: To implement an arterial spin labeling technique that is feasible in routine examinations and to test the method and compare it with dynamic susceptibility-weighted contrast material–enhanced magnetic resonance (MR) imaging for evaluation of tumor blood flow (TBF) in patients with brain tumors.
MATERIALS AND METHODS: Thirty-six patients with histologically proven brain tumors were examined at 1.5 T. A second version of quantitative imaging of perfusion by using a single subtraction with addition of thin-section periodic saturation after inversion and a time delay (Q2TIPS) technique of pulsed arterial spin labeling in the multisection mode was implemented. After arterial spin labeling, a combined T2- and T2*-weighted first-pass bolus perfusion study (gadopentetate dimeglumine, 0.2 mmol/kg) was performed by using a double-echo echo-planar imaging sequence. In regions of interest, maps of absolute and relative cerebral blood flow were computed and analyzed with arterial spin labeling and dynamic susceptibility-weighted contrast-enhanced MR imaging, respectively.
RESULTS: Both techniques yielded the highest perfusion values in imaging of glioblastomas and the lowest values in imaging of two low-grade gliomas that both showed strong gadopentetate dimeglumine enhancement. There was a close linear correlation between dynamic susceptibility-weighted contrast-enhanced MR imaging and arterial spin labeling in the tumor region of interest (linear regression coefficient, R = 0.83; P < .005). Blood flow is underestimated with arterial spin labeling at low flow rates. High- and low-grade gliomas can be distinguished at the same level of significance with both methods. Absolute TBF is less important for tumor grading than is the ratio of TBF to age-dependent mean brain perfusion.
CONCLUSION: Arterial spin labeling is a suitable method for assessment of microvascular perfusion and allows distinction between high- and low-grade gliomas.
© RSNA, 2003
Index terms: Brain, perfusion, 10.12144 • Brain neoplasms, diagnosis, 10.36, 10.38 • Magnetic resonance (MR), perfusion study, 10.121411, 10.121412, 10.12143, 10.12149 • Neoplasms, metastases, 00.33, 60.33, 84.33, 854.33
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