Fargol Booya MD, Abstract Co-Author: Nothing to Disclose

David Brian Hackney MD, Presenter: Nothing to Disclose

David C. Alsop PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy of arterial spin labeling technique for differentiation of tumor necrosis from recurrence in patients with brain tumors.  

Thirty five patients with forty three histologically proven brain tumors who were treated with radiation or chemo-radiation and had enhancing lesions at the site of primary tumor treatment in the follow up imaging were included.  In each patient, ASL study was  interpreted as tumor or not. Using enhanced MRI study as road map, the uptake/ perfusion of the lesion and the normal white matter were measured.  The results were compared with gold standard (pathology and/or long term clinical follow up).  

In tumor recurrence, ASL perfusion ratio was 5.9 + 2.1. All recurrences had  perfusion greater than 50 cc/min/gram. In radiation necrosis the uptake or perfusion were equal to or less than normal white matter and reliable ROI could not be placed. No radiation necrosis had perfusion greater than 29 cc/min/gram . The ASL was concordant with gold standard in 40/43 lesions.

ASL is highly accurate for differention of recurrence from radiation necrosis.

Since ASL is a 5 minute acquisition at the time of MR imaging, collecting perfusion data with ASL is an efficient approach to diagnostic question.

Booya, F, Hackney, D, Alsop, D, ASL MR Perfusion Is Highly Accurate in Distinguishing Recurrent Tumor from Radiation Necrosis.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015891.html