Three-dimensional arterial spin labeling imaging and dynamic susceptibility contrast perfusion-weighted imaging value in diagnosing glioma grade prior to surgery

Abstract

The current study aimed to investigate whole-brain three-dimensional arterial spin labeling imaging (3D ASL) and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI), in regards to their diagnostic value of preoperative glioma grade. The parameter values obtained after correction will be correlated with the diagnostic value of 3D ASL and DSC-PWI perfusion. In the current study, 50 patients with gliomas confirmed by pathology were used, including 27 low-grade gliomas (LGGs) and 23 high-grade gliomas (HGGs). Prior to surgery all patients underwent 3 Tesla magnetic resonance imaging (MRI), 3D ASL, DSC-PWI and conventional enhanced MRI scans to obtain original 3D ASL and DSC-PWI images, and the tumor regions with the most obvious parenchyma perfusion and contralateral normal white matter were selected. In these areas, the ASL-relative cerebral blood flow (ASL-rCBF), DSC-relative cerebral blood flow (DSC-rCBF) and DSC-relative cerebral blood volume (DSC-rCBV) parameter values were then obtained after correction for individual differences. The results of the present study show that ASL-CBF, DSC-CBF, DSC-CBV values and ASL-rCBF, DSC-rCBF, DSC-rCBV values increased as the grade of the glioma being imaged increased, and there was a marked difference between the HGGs and the LGGs. ASL-rCBF was significantly positively correlated with DSC-rCBF (r=0.580, P<0.01). In addition, ASL-rCBF was significantly positively correlated with DSC-rCBV (r=0.431, P<0.01). Receiver operating characteristic (ROC) curves were applied to compare the two perfusion parameters of DSC-PWI and 3D ASL in the diagnosis of glioma grade. ASL-rCBF had the highest area value under the ROC curve (0.836). The areas under the ROC curve of DSC-rCBF and DSC-rCBV were analyzed using the Z test, but the difference was not statistically significant. When ASL-rCBF, DSC-rCBF and DSC-rCBV were cutoff at 2.24, 1.85 and 1.68, the sensitivity of HGG diagnosis was 83.2, 91.3 and 91.3%, and the specificity was 77.7, 63.9 and 66.7%, respectively.

Comparing amide proton transfer imaging with dynamic susceptibility contrast-enhanced perfusion in predicting histological grades of gliomas: a meta-analysis

“…The remaining 23 studies were included in the analysis. Eight studies evaluated APT (11–16,18,19) and 16 studies evaluated DSC with the parameter rCBV (6,14,20–33).…”

Application of MRS- and ASL-guided navigation for biopsy of intracranial tumors

“…However, DSC-MRI involves the use of contrast agents and may be contraindicated in patients with renal problems. ASL, which can non-invasively evaluate the tumor microcirculation and degree of tumor angiogenesis, is an attractive alternative (16,17). Multiple studies have shown that ASL is highly comparable to DSC-MRI in the evaluation of the tumor microcirculation (18).…”

“…Dysfunctional vascularity is an indicator of high malignancy (10). Arterial spin labeling (ASL) is a non-invasive technique that uses free water protons in the arterial blood as an endogenous tracer to quantify blood flow within the lesion, and it has been used to assess the microvascular density of glial tumors and quantify tumor regions with abnormally elevated perfusion (11,12). However, ASL usually shows an area of high perfusion whose volume is obviously larger than that of the biopsy needle tip; this reduces the accuracy of biopsy.…”

Patch-based super-resolution of arterial spin labeling magnetic resonance images

“…Although linear correlation between ASL and DSC relative CBF has not been strictly demonstrated, in a first approximation as shown in [24,25,26], we assume that positive correlations should be obtained between both estimations. Therefore, the Pearson correlation coefficients were calculated between the low resolution ASL CBF and the registered HR DSC CBF maps, and the SR reconstructed ASL CBF and DSC CBF maps.…”