Velocity-Selective arterial spin labeling (VSASL) for cerebral blood volume assessment in gliomas: comparison with VSASL based cerebral blood flow and dynamic susceptibility contrast MRI.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-09-02 DOI:10.1007/s00234-025-03751-6

Yaoming Qu, Andong Ma, Xinran Yan, Xiaochan Ou, Xia Zou, Qihong Rui, Haitao Wen, Xianlong Wang, Dan Zhu, Qin Qin, Zhibo Wen

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引用次数: 0

Abstract

Purpose: Cerebral blood volume (CBV) maps created using dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) are valuable but may be limited by gadolinium contraindications in certain clinical scenarios. A noninvasive perfusion method for CBV assessment based on velocity-selective (VS) ASL has emerged. This study is to evaluate the performance of VSASL-derived CBV among glioma patients in clinical practice, comparing with the VSASL-based cerebral blood flow (CBF) and DSC-PWI.

Methods: Forty-eight patients with pathologically confirmed gliomas (mean age: 45 ± 13 years; 25 males; 25 in low-grade) underwent preoperative VSASL-CBV MRI. Lesion conspicuity on VSASL-CBV maps was visually scored (1-3) relative to surrounding parenchyma by two neuroradiologists. Relative maximum tumor blood volume (rTBV) and flow (rTBF) from VSASL and DSC-PWI were compared between low- and high-grade gliomas. Correlation and agreement between VSASL- and DSC-PWI-derived rTBV were assessed via linear regression and Bland-Altman analysis. Diagnostic performance for glioma grading was evaluated using ROC curves.

Results: VSASL-CBV maps demonstrated good lesion conspicuity (mean score: 2.26 ± 0.76; inter-reader weighted κ = 0.8). VSASL-rTBV strongly correlated with DSC-PWI-rTBV (R²=0.83, p < 0.001). Both VSASL and DSC-PWI metrics significantly distinguished low- from high-grade gliomas (p < 0.001). ROC analysis revealed that VSASL-rTBV achieved excellent diagnostic accuracy in glioma grading (AUC = 0.94), outperforming VSASL-rTBF (AUC = 0.89) and matching DSC-PWI-rTBV (AUC = 0.93). Sensitivity, predictive values, and accuracy of VSASL-rTBV were superior to VSASL-rTBF.

Conclusion: VSASL provides accurate, noninvasive CBV quantification for glioma stratification, demonstrating diagnostic performance comparable to DSC-PWI. It offers a viable alternative in clinical settings where gadolinium contrast is contraindicated.

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速度选择性动脉自旋标记（VSASL）用于胶质瘤脑血容量评估：与基于VSASL的脑血流量和动态敏感性对比MRI的比较

目的：使用动态敏感性对比增强灌注加权成像（DSC-PWI）绘制脑血容量（CBV）图是有价值的，但在某些临床情况下可能受到钆禁忌症的限制。一种基于速度选择性（VS） ASL的无创血流灌注评估方法已经出现。本研究旨在通过与脑血管血流量（CBF）和DSC-PWI的比较，评价脑血管血流量在胶质瘤患者临床应用中的表现。方法：48例经病理证实的胶质瘤患者（平均年龄45±13岁，男性25例，低级别25例）术前行VSASL-CBV MRI检查。两名神经放射科医生对VSASL-CBV图上病变的显著性相对于周围实质进行了视觉评分（1-3）。通过VSASL和DSC-PWI比较低级别和高级别胶质瘤的相对最大肿瘤血容量（rTBV）和血流（rTBF）。通过线性回归和Bland-Altman分析评估VSASL和dsc - pwi衍生的rTBV之间的相关性和一致性。使用ROC曲线评估胶质瘤分级的诊断性能。结果：VSASL-CBV图表现出良好的病变显著性（平均评分：2.26±0.76；读间加权κ = 0.8）。结论：VSASL为胶质瘤分层提供了准确、无创的CBV定量，其诊断性能与DSC-PWI相当。它提供了一个可行的替代临床设置，钆造影剂是禁忌症。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.