Comparison of arterial spin labeling and dynamic susceptibility-weighted contrast-enhanced MR imaging in brain tumors

RATIONALE AND OBJECTIVES: The purpose of this study was to compare unenhanced arterial spin-labeled (ASL) imaging and dynamic susceptibility contrast-enhanced perfusion (DSCE) Magnetic Resonance Imaging for evaluation of tumor perfusion in patients with brain tumors. MATERIALS &METHODS: Between March 2011- May 2013, 27 patients with brain tumors were examined with 1,5 T MRI. Singlephase /multiphase ASL and DSCE perfusion examinations were assessed by both qualitative and quantitative analysis for the detection of malignancy. Imaging tests were correlated with histopathological results or follow-up. RESULTS: Thirty one ASL & DSCE perfusion examinations of 27 patients (4 re-evaluated cases) were evaluated. On the basis of visual inspection, the sensitivity values of ASL and DSCE perfusion examinations for detecting malignant tumor were 88% and 94%, respectively. With a cut-off ratio of 1.65, sensitivity and specificity values for quantitative ASL imaging were 94% and 50%, rspectively. When the cut-off ratio for quantitative DSC imaging was accepted as 1.95, sensitivity and specificity values were 94% and 57%, respectively. CONCLUSION: Arterial Spin Labeling perfusion technique is a non-invasive and useful method for the evaluation of perfusion in brain tumours. The results of this study revealed that ASL perfusion and Dynamic Contrast-enhanced perfusion MRI techniques show similar sensitivity values. So, ASL is a promising technique which seems to be more widely used in clinical research and practice alternative to DSCE in the future. Key words: Brain tumors, perfusion, arterial spin-labeled (ASL) MRI, dynamic susceptibility contrast-enhanced MR imaging ( DSCE