Differentiation between radiation-induced brain injury and glioma recurrence using 3D pCASL and dynamic susceptibility contrast-enhanced perfusion-weighted imaging

摘要

PurposeThis study was performed to validate the efficacy of three-dimensional pseudocontinuous arterial spin labeling (pCASL) compared with dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) in distinguishing radiation-induced brain injury from glioma recurrence in patients with glioma. MethodsBoth 3D pCASL and DSC-PWI were performed using a 3.0?Tesla scanner in 69 patients with previously resected and irradiated glioma who displayed newly developed abnormal contrast-enhanced lesions. The included patients were classified into a radiation-induced brain injury group (n?=?34) and a glioma recurrence group (n?=?35) based on subsequent pathologic analysis or clinical–radiological follow-up. Lesion perfusion parameter values (CBF and nCBF on pCASL, nrCBV and nrCBF on DSC-PWI) were measured and compared between the two groups using Student’sttest. Pearson correlation analysis was performed to evaluate the correlation between pCASL (CBF and nCBF) and DSC-PWI (nrCBV and nrCBF) values in the contrast-enhanced lesions and in the perifocal edema regions. ResultsFor the contrast-enhanced lesions, the CBF, nCBF, nrCBV, and nrCBF (29.46?±?15.08?ml/100?g/min, 1.11?±?0.50, 1.39?±?1.15, and 1.30?±?0.74) in the radiation-induced brain injury group were significantly lower than those (64.52?±?33.92?ml/100?g/min, 2.73?±?1.71, 3.39?±?2.12, and 3.20?±?1.95) in the glioma recurrence group (P?