Effects of Susceptibility Artifacts on Perfusion MRI in Patients with Primary Brain Tumor: A Comparison of Arterial Spin-Labeling versus DSC

AJNR Am J Neuroradiol. 2020 Feb;41(2):255-261. doi: 10.3174/ajnr.A6384. Epub 2020 Jan 23.

Abstract

Background and purpose: Our aim was to investigate the effects of intratumoral hemorrhage, calcification, and postoperative changes on the sensitivity of arterial spin-labeling and DSC perfusion MR imaging in patients with primary brain tumors.

Materials and methods: Eighty-six brain tumor lesions were examined with single-phase and multiphase arterial spin-labeling and DSC perfusion MR imaging. The lesions that had no intratumoral bleeding/calcifications and history of surgery were assigned to group 1 (n = 38), and the lesions that had these were assigned to group 2 (n = 48). The relative regional cerebral blood flow was calculated in both perfusion methods, and relative regional cerebral blood volume was calculated in DSC. Imaging results were correlated with histopathology or follow-up.

Results: In the quantitative evaluation, the sensitivity and specificity of relative regional cerebral blood flow in multiphase arterial spin-labeling perfusion were 94.4% and 80% in group 1 and 78.3% and 88% in group 2, respectively. The sensitivity and specificity of relative regional cerebral blood flow in DSC perfusion were 88.9% and 75% in group 1 and 78.3% and 84% in group 2, respectively. The sensitivity and specificity of relative regional cerebral blood volume in DSC perfusion were 66.7% and 100% in group 1 and 69.6% and 96% in group 2, respectively. In the qualitative evaluation, the sensitivities for single-phase and multiphase arterial spin-labeling were 48.2% and 79.3%, respectively, with 100% specificity for both.

Conclusions: The sensitivity and specificity of multiphase arterial spin-labeling were similar to those of DSC perfusion irrespective of bleeding and calcification in primary brain tumors. Thus, we suggest that noncontrast multiphase arterial spin-labeling can be used instead of DSC perfusion MR imaging in the diagnosis and follow-up of intracranial tumors.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Artifacts*
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Contrast Media
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neuroimaging / methods*
  • Perfusion Imaging / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spin Labels

Substances

  • Contrast Media
  • Spin Labels