Evaluation of intracranial tumors using contrast and non-contrast MRI perfusion sequences
Abstract Background Early diagnosis and accurate follow-up of brain tumors are essential. Advanced neuroimaging magnetic imaging resonance (MRI) techniques enhance diagnostic precision. Recently, advanced MRI techniques, including perfusion imaging, have been used to assess not only the anatomical f...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-07-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-025-01512-2 |
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| Summary: | Abstract Background Early diagnosis and accurate follow-up of brain tumors are essential. Advanced neuroimaging magnetic imaging resonance (MRI) techniques enhance diagnostic precision. Recently, advanced MRI techniques, including perfusion imaging, have been used to assess not only the anatomical features of the tumor but also the tissue’s cellularity, metabolism, and vascularity. Objective To differentiate between the outcome of two distinct MRI perfusion techniques, i.e., arterial spin labeling; ASL (non-contrast MRI perfusion) technique and dynamic susceptibility contrast; and DSC (contrast MRI perfusion) technique in the evaluation of intra-axial brain tumors. Results Spearman’s correlation coefficient suggests a moderate-to-strong significant positive correlation between ASL and DSC performance (p value < 0.05). ASL-rCBF exhibited a significant positive correlation with tumor size (r = 0.454, p = 0.003), whereas DSC-rCBV showed a weaker, non-significant correlation (r = 0.186, p = 0.244). A strong negative correlation was found between both perfusion parameters and apparent diffusion coefficient (ADC) values (p < 0.001). ASL-rCBF also positively correlated significantly with metabolic markers, including Cho/Cr (r = 0.545, p < 0.001) and Cho/NAA (r = 0.438, p = 0.005). The diagnostic performance of DSC findings in relation to pathology showed a good sensitivity of about 79% and an excellent specificity of nearly 100%, whereas the diagnostic performance of ASL findings in relation to pathology showed very good sensitivity and specificity of ASL of about 81.6% and 75%, respectively. Conclusion Both ASL and DSC perfusion techniques provide valuable quantitative insights into tumor perfusion. ASL, despite its non-contrast nature, demonstrates comparable diagnostic performance to DSC. ASL also exhibits a stronger correlation with tumor size and metabolic activity. While DSC remains the gold standard, ASL offers a viable alternative for patients with contraindications to contrast media. ASL and DSC perfusion imaging shows a significant degree of concordance in their application for diagnosing intracranial tumors. Therefore this close correlation highlights their utility and interchangeability in clinical practice for evaluating tumor characteristics. |
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| ISSN: | 2090-4762 |