Arterial Spin Labeling and Dynamic Susceptibility Contrast-Enhanced Perfusion MRI in Evaluation of Adult Patients with Gliomas

Authors

  • Dawlat N. I. Eltatawy
  • Fatma A. Elsharawy
  • Sameh A. Khodair
  • Hanan S. Mahmoud
  • Hanan M. S. El-Ahwal

Keywords:

Arterial Spin Labeling, Dynamic Susceptibility Contrast, Magnetic Resonance Imaging, Gliomas

Abstract

Objectives: To highlight the role of ASL and DSC perfusion MRI in the diagnosis, grading, and follow-up of adult patients with gliomas.

Methods: This prospective study was carried out on 40 patients  with MRI features of glioma either for grading or for follow up ,aged from 19 to 68 years old. Non-contrast ASL followed by DSC-PI was done for all cases. The final diagnosis of the cases was established by histopathology.

Results: There was a highly strong correlation between absolute ASL- tumoral cerebral blood flow (tCBF) and absolute DSC -tCBF and DSC-cerebral blood volume (tCBV). ASL- tCBF was significantly different between IDH multiform (GBM) and IDH multiforme (GBM) residual after radiotherapy and chemotherapy. Both ASL and DSCE qualitative color maps showed significant difference between low and high glioma grades. Both ASL-tCBF and ASL –rCBF had sensitivity of 91.9% ,specificity of 90.9 % ,PPV of 91.9% and NPV of 91.9% . DSC-tCBV had sensitivity of 91.6%, specificity of 81.8%, PPV of 84.6% and NPV of 90%.

Conclusions: ASL can serve as a good alternative for dynamic contrast-enhanced perfusion MRI in preoperative grading as well as in follow up of gliomas.

Downloads

Download data is not yet available.

References

Qu Y, Kong D, Wen H, Ou X, Rui Q, Wang X, et al. Perfusion measurement in brain gliomas using velocity-selective arterial spin labeling: comparison with pseudo-continuous arterial spin labeling and dynamic susceptibility contrast MRI. Eur J Radiol. 2022;32:2976-87.

McKinnon C, Nandhabalan M, Murray SA, Plaha P. Glioblastoma: clinical presentation, diagnosis, and management. BMJ. 2021;374:200-30.

Blionas A, Giakoumettis D, Klonou A, Neromyliotis E, Karydakis P, Themistocleous MS. Paediatric gliomas: diagnosis, molecular biology and management. Ann Transl Med. 2018;60:400-30.

Verburg N, de Witt Hamer PC. State-of-the-art imaging for glioma surgery. Neurosurg Rev. 2021;44:1331-43.

Nilsen LB, Emblem KE. Magnetic resonance imaging for quantification of brain vascular perfusion. Brain Tumors. 2021;30:289-321.

Ninatti G, Sollini M, Bono B, Gozzi N, Fedorov D, Antunovic L, et al. Preoperative [11C] methionine PET to personalize treatment decisions in patients with lower-grade gliomas. Neuro-oncol. 2022;24:1546-56.

Castellano A, Bailo M, Cicone F, Carideo L, Quartuccio N, Mortini P, et al. Advanced imaging techniques for radiotherapy planning of gliomas. Cancers. 2021;13:10-63.

Abdelgawad MS, Kayed MH, Reda MIS, Abdelzaher E, Farhoud AH, Elsebaie N. Contribution of advanced neuro-imaging (MR diffusion, perfusion and proton spectroscopy) in differentiation between low grade gliomas GII and MR morphologically similar non neoplastic lesions. EJNM. 2022;53:20-6.

Anzalone N, Castellano A, Cadioli M, Conte GM, Cuccarini V, Bizzi A, et al. Brain gliomas: multicenter standardized assessment of dynamic contrast-enhanced and dynamic susceptibility contrast MR images. J Radiol. 2018;287:933-43.

Waqar M, Lewis D, Agushi E, Gittins M, Jackson A, Coope D. Cerebral and tumoral blood flow in adult gliomas: a systematic review of results from magnetic resonance imaging. Br J Radiol. 2021;94:30-5.

Weller M, Wick W, Aldape K, Brada M, Berger M, Pfister SM, et al. Glioma. Nat Rev Dis. 2015;10:1-18.

Mohammadi E, Moghaddam SS, Azadnajafabad S, Maroufi SF, Rashidi MM, Naderian M, et al. Epidemiology of brain and other central nervous system cancers in the north africa and middle east region: a systematic analysis of the global burden of disease study 1990-2019. World Neurosurg. 2023;171:796-819.

ElBeheiry AA, Emara DM, Abdel-Latif AA-B, Abbas M, Ismail AS. Arterial spin labeling in the grading of brain gliomas: could it help? EJNM. 2020;51:1-11.

Bayraktar ES, Duygulu G, Çetinoğlu YK, Gelal MF, Apaydın M, Ellidokuz H. Comparison of ASL and DSC perfusion methods in the evaluation of response to treatment in patients with a history of treatment for malignant brain tumor. BMC Med Imaging. 2024;24:70-60.

Brendle C, Hempel JM, Schittenhelm J, Skardelly M, Tabatabai G, Bender B, et al. Glioma grading and determination of IDH mutation status and ATRX loss by DCE and ASL perfusion. Clin Neuroradiol. 2018;28:421-8.

Youssef A, Al Neikedy A, Khater H, Hanora M. Role of arterial spin labelling cerebral perfusion in assessment of different intra cranial disorders (using 3 Tesla MRI). BJAS. 2021;6:333-41.

Batalov AI, Zakharova NE, Pronin IN, Belyaev AY, Pogosbekyan EL, Goryaynov SA, et al. 3D pCASL-perfusion in preoperative assessment of brain gliomas in large cohort of patients. Sci Rep. 2022;12:21-2.

Zeng Q, Jiang B, Shi F, Ling C, Dong F, Zhang J. 3D pseudocontinuous arterial spin-labeling MR imaging in the preoperative evaluation of gliomas. AJNR Am J Neuroradiol. 2017;38:1876-83.

Alsaedi A, Doniselli F, Jäger HR, Panovska-Griffiths J, Rojas-Garcia A, Golay X, et al. The value of arterial spin labelling in adults glioma grading: systematic review and meta-analysis. Oncotarget. 2019;10:15-89.

Petr J, Platzek I, Seidlitz A, Mutsaerts HJ, Hofheinz F, Schramm G, et al. Early and late effects of radiochemotherapy on cerebral blood flow in glioblastoma patients measured with non-invasive perfusion MRI. Radiother Oncol. 2016;118:24-8.

Guo D, Jiang B. Noninvasively evaluating the grade and IDH mutation status of gliomas by using mono-exponential, bi-exponential diffusion-weighted imaging and three-dimensional pseudo-continuous arterial spin labeling. Eur J Radiol. 2023;160:110-721.

Wang YL, Chen S, Xiao HF, Li Y, Wang Y, Liu G, et al. Differentiation between radiation-induced brain injury and glioma recurrence using 3D pCASL and dynamic susceptibility contrast-enhanced perfusion-weighted imaging. Radiother Oncol. 2018;129:68-74.

Patil V, Malik R, Sarawagi R. Comparative study between dynamic susceptibility contrast magnetic resonance imaging and arterial spin labelling perfusion in differentiating low-grade from high-grade brain tumours. Pol J Radiol. 2023;88:521-8.

Arisawa A, Watanabe Y, Tanaka H, Takahashi H, Matsuo C, Fujiwara T, et al. Comparative study of pulsed-continuous arterial spin labeling and dynamic susceptibility contrast imaging by histogram analysis in evaluation of glial tumors. Neuroradiol. 2018;60:599-608.

Su H, Kong X, Su S, Wu K, Shi H. The value of arterial spin labeling and dynamic susceptibility contrast in the differential diagnosis of the recurrence of glioma. Invest Clin. 2020;61:949-57.

Nguyen TB, Zakhari N, Velasco Sandoval S, Guarnizo-Capera A, Alexios Gulak M, Woulfe J, et al. Diagnostic accuracy of arterial spin-labeling, dynamic contrast-enhanced, and DSC perfusion imaging in the diagnosis of recurrent high-grade gliomas: a prospective study. AJNR Am J Neuroradiol. 2023;44:134-42.

Downloads

Published

2025-06-16

How to Cite

1.
N. I. Eltatawy D, Elsharawy FA, A. Khodair S, S. Mahmoud H, El-Ahwal HMS. Arterial Spin Labeling and Dynamic Susceptibility Contrast-Enhanced Perfusion MRI in Evaluation of Adult Patients with Gliomas. J Neonatal Surg [Internet]. 2025Jun.16 [cited 2025Jul.19];14(32S):293-307. Available from: https://jneonatalsurg.com/index.php/jns/article/view/7368