{"title":"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","authors":"Yaoming Qu, Andong Ma, Xinran Yan, Xiaochan Ou, Xia Zou, Qihong Rui, Haitao Wen, Xianlong Wang, Dan Zhu, Qin Qin, Zhibo Wen","doi":"10.1007/s00234-025-03751-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Yaoming Qu, Andong Ma, Xinran Yan, Xiaochan Ou, Xia Zou, Qihong Rui, Haitao Wen, Xianlong Wang, Dan Zhu, Qin Qin, Zhibo Wen\",\"doi\":\"10.1007/s00234-025-03751-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03751-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03751-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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.
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
