scholarly journals Clinical Applications of Contrast-Enhanced Perfusion MRI Techniques in Gliomas: Recent Advances and Current Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-27 ◽  
Author(s):  
Junfeng Zhang ◽  
Heng Liu ◽  
Haipeng Tong ◽  
Sumei Wang ◽  
Yizeng Yang ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Imaging Techniques ◽  
Malignant Gliomas ◽  
Response Assessment ◽  
Clinical Applications ◽  
Vascular Pathology ◽  
Molecular Characteristics ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Contrast Enhanced

Gliomas possess complex and heterogeneous vasculatures with abnormal hemodynamics. Despite considerable advances in diagnostic and therapeutic techniques for improving tumor management and patient care in recent years, the prognosis of malignant gliomas remains dismal. Perfusion-weighted magnetic resonance imaging techniques that could noninvasively provide superior information on vascular functionality have attracted much attention for evaluating brain tumors. However, nonconsensus imaging protocols and postprocessing analysis among different institutions impede their integration into standard-of-care imaging in clinic. And there have been very few studies providing a comprehensive evidence-based and systematic summary. This review first outlines the status of glioma theranostics and tumor-associated vascular pathology and then presents an overview of the principles of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast-MRI (DSC-MRI), with emphasis on their recent clinical applications in gliomas including tumor grading, identification of molecular characteristics, differentiation of glioma from other brain tumors, treatment response assessment, and predicting prognosis. Current challenges and future perspectives are also highlighted.

Efficacy of endovascular intratumoral embolization for meningioma: assessment using dynamic susceptibility contrast-enhanced perfusion-weighted imaging

2021 ◽  
pp. neurintsurg-2020-017116
Author(s):  
Katsunori Asai ◽  
Hajime Nakamura ◽  
Yoshiyuki Watanabe ◽  
Takeo Nishida ◽  
Mio Sakai ◽  
...  
Keyword(s):  
Intracranial Meningioma ◽  
Preoperative Embolization ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Perfusion Weighted Imaging ◽  
Contrast Enhanced ◽  
Before And After ◽  
Reduction Effect ◽  
Susceptibility Contrast ◽  
Bare Platinum Coils

BackgroundIn preoperative embolization for intracranial meningioma, endovascular intratumoral embolization is considered to be more effective for the reduction of tumorous vascularity than proximal feeder occlusion. In this study, we aimed to reveal different efficacies for reducing tumor blood flow in meningiomas by comparing endovascular intratumoral embolization and proximal feeder occlusion using dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).Methods28 consecutive patients were included. DSC-PWI was performed before and after embolization for intracranial meningiomas. Normalized tumor blood volume (nTBV) of voxels of interest of whole tumors were measured from the DSC-PWI data before and after embolization. ΔnTBV% was compared between the cases that received intratumoral embolization and proximal feeder occlusion.ResultsΔnTBV% in the intratumoral embolization group (42.4±29.8%) was higher than that of the proximal feeder occlusion group (15.3±14.3%, p=0.0039). We used three types of embolic materials and ΔnTBV% did not differ between treatments with or without the use of each material: 42.8±42.4% vs 28.7±20.1% for microspheres (p=0.12), 36.1±20.6% vs 28.1±41.1% for n-butyl cyanoacrylate (p=0.33), and 32.3±37.3% vs 34.1±19.0% for bare platinum coils (p=0.77).ConclusionsThe flow reduction effect of intratumoral embolization was superior to that of proximal feeder occlusion in preoperative embolization for intracranial meningioma in an assessment using DSC-PWI.

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