The potentiality of arterial spins labeling (ASL) magnetic resonance perfusion technique for the diagnosis of glioblastoma residual tissue

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Background: Growing glioblastoma is associated with an impairment of the blood brain barrier and increased hemodynamic parameters (CBV, CBF), which is related to advanced tumor angiogenesis. Arterial spin labeling (ASL) perfusion, an additional study to the routine intravenous contrast-enhanced magnetic resonance imaging (MRI), may be a technique for assessment of hemodynamics and identification of the residual tumor tissue.

Aim: To study the potential of native ASL to assess hemodynamic parameters and detect residual tumor tissue in the patients who had undergone surgical resection of glioblastoma.

Materials and methods: At 2 to 4  weeks after surgery for glioblastoma grade IV, brain MRI with native ASL perfusion and subsequent intravenous contrast enhancement was performed in 63  patients. Cerebral blood flow (CBF) values were measured in three areas of interest: in the presumptive tumor tissue (PTT) with maximal perfusion, in the postoperative scar tissue (PST) and in the deep white matter (DWM) of the contralateral hemisphere.

Results: According to their CBF values, all patients were categorized into two groups. Group 1 included 43  patients (68.3%) with mean CBF in PTT of 135.4±41.3  ml/100  Gr/min (min 73.9, max 255.9). These values were 5 to 6-fold higher than the CBF values in the PST and 6 to 8-fold higher than those in DWM. Group  2 included 20  patients (31.7%) without any areas of abnormal CBF increase in PST, with its mean value of 22.1±5.6  ml/100  Gr/min (min 13.9, max 37.1), which was close to the CBF level in DWM (19.8±4.6  ml/100  Gr/min, p=0.06). There were no between-group differences for the CBF values in PST (p=0.6), and DWM (p=0.7).

Conclusion: ASL MR perfusion technique has good potential for the identification of residual tumor tissue after surgical resection of glioblastoma and can be an alternative to contrast enhancement during long-term follow up.

About the authors

M. S. Bunak

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
ORCID iD: 0000-0001-6436-0249

Mark S. Bunak – Junior Research Fellow, Radiology Department

61/2–1 Shchepkina ul., Moscow, 129110

Russian Federation

E. A. Stepanova

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0002-9037-0034

Elena A. Stepanova – MD, PhD, Chief Research Fellow, Diagnostic Department

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

G. A. Stashuk

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0003-1058-0611

Galina A. Stashuk – MD, PhD, Head of Radiology Department No. 2

61/2 Shchepkina ul., Moscow, 129110

Russian Federation


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Copyright (c) 2021 Bunak M.S., Stepanova E.A., Stashuk G.A.

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