A comparison of arterial spin labeling and dynamic susceptibility perfusion imaging for resection control in glioblastoma surgery
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Thomas Lindner1,*, Hajrullah Ahmeti2,*, Julia Juhasz1, Michael Helle3, Olav Jansen1, Michael Synowitz2 and Stephan Ulmer1
1Clinic for Radiology and Neuroradiology, UKSH Kiel, Kiel, Germany
2Clinic for Neurosurgery, UKSH Kiel, Kiel, Germany
3Philips Research Laboratories, Hamburg, Germany
*These authors contributed equally to this work
Thomas Lindner, email: [email protected]
Keywords: magnetic resonance; imaging; perfusion; glioblastoma; in-vivo
Received: November 19, 2017 Accepted: March 18, 2018 Published: April 06, 2018
Resection control using magnetic resonance imaging during neurosurgical interventions increases confidence regarding the extent of tumor removal already during the procedure. In addition to morphological imaging, functional information such as perfusion might become an important marker of the presence and extent of residual tumor mass. The aim of this study was to implement arterial spin labeling (ASL) perfusion imaging as a noninvasive alternative to dynamic susceptibility contrast (DSC) perfusion imaging in patients suffering from intra-axial tumors for resection control already during surgery. The study included 15 patients suffering from glioblastoma multiforme in whom perfusion imaging using DSC and ASL was performed before, during, and after surgery. The data obtained from intraoperative scanning were analyzed by two readers blinded to any clinical information, and the presence of residual tumor mass was evaluated using a ranking scale. Similarity of results was analyzed using the intraclass correlation coefficient and Pearson’s correlation coefficient. The results show that intraoperative ASL is as reliable as DSC when performing intraoperative perfusion imaging. According to the results of this study, intraoperative imaging using ASL represents an attractive alternative to contrast agent-based perfusion imaging.
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