Comparison of arterial spin labeling technique with Dynamic susceptibility contrast technique of Perfusion mr imaging in enhancing brain tumors

Abstract

BACKGROUND: MR perfusion has significant role in evaluation of intracranial neoplasms which helps to estimate neo-angiogenesis of tumor for grading, guiding stereotactic biopsies, surgical planning, differentiating recurrent tumor from radiation necrosis, differentiating high grade glioma from metastases / lymphoma and therapeutic response assessment for new clinical trials on anti-angiogenic agents. Three MR perfusion techniques are currently in use: dynamic contrast-enhanced (DCE), dynamic susceptibility contrast (DSC), and arterial spin labelling (ASL). DSC technique is most widely used and studied in literature with extensive clinical experience which requires contrast administration. Arterial spin labelling (ASL) is a novel technique which has been studied in the recent years for clinical use. It provides qualitative and quantification evaluation of CBF maps by using arterial water as an endogenous tracer by labelling blood water protons in cerebral arteries without the requirement of contrast agent.