MR Perfusion Imaging
Christine Preibisch, Vivien Tóth, and Claus Zimmer
Contents
1 |
Key Points............................................................................ |
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2 |
Methods................................................................................ |
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2.1 |
Exogenous Tracer Methods................................................... |
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2.2\ |
Endogenous Tracer Methods: Arterial Spin Labeling........... |
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3 |
Clinical Application............................................................ |
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3.1 |
General Aspects..................................................................... |
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3.2\ |
Pathophysiological Background: Neovascularization |
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in Brain Tumors.................................................................... |
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3.3\ |
Differential |
Diagnosis of Tumors.......................................... |
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3.4\ |
Tumor |
Grading and Prognosis.............................................. |
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3.5\ |
Guidance |
for Biopsy and Radiation Therapy Planning......... |
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3.6 |
Treatment Monitoring........................................................... |
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References..................................................................................... |
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Abstract
Perfusion imaging is a powerful tool in the imaging of brain tumors, improving differential diagnostics, tumor grading, and the planning and monitoring of different therapy modalities. Several technical approaches are available to characterize tumor perfusion; these methods are widely available, easy to apply, and the results provide essential additional information on brain tumor pathophysiology. This chapter provides a review of different perfusion measurement techniques with exogenous or endogenous tracers. The clinical application of perfusion measurements in neuro-oncological imaging is discussed in view of the pathophysiological background. The practical use of perfusion imaging in differential diagnosis and tumor grading is presented with regard to the prognostic value of the method. Applications in biopsy targeting and therapy planning are also discussed. In the last section of this chapter, advantages and limitations of perfusion imaging in the follow-up of brain tumors are summarized.
Abbreviations
DSC\ |
Dynamic susceptibility contrast |
DCE\ |
Dynamic contrast enhanced |
CBF\ |
Cerebral blood flow [mL/100 mL/min] |
CBV\ |
Cerebral blood volume [mL/100 mL] |
MTT\ |
Mean transit time |
TTP\ |
Time to peak |
AIF\ |
Arterial input function |
Ktrans\ |
Transfer coefficient |
C. Preibisch • V. Tóth • C. Zimmer (*)
Department of Neuroradiology, Klinikum Rechts der Isar, TU Munich, Munich, Germany
e-mail: claus.zimmer@tum.de
E. Hattingen, U. Pilatus (eds.), Brain Tumor Imaging, Medical Radiology. Diagnostic Imaging,
DOI: 10.1007/174_2016_954, © Springer-Verlag Berlin Heidelberg 2016
1\ Key Points
•Tumor vessels are tortuous, wide, highly dense, and per- meable—resulting in perfusion anomalies.
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