• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.120-132
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• 2014

Purpose : To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weighted imaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patients treated with RT for primary brain tumors. Materials and Methods: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newly appearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions were confirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume (nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for the enhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regression model was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtained from receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy for the diagnosis. Results: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004), and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference was observed in the mean ADC values between the two groups. A multivariable logistic regression analysis showed that proSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11 of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively. Conclusion: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesions more than one year after RT completion in brain tumor patients.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.323-331
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• 2011

We evaluated clinical usefulness of Arterial spin labeling perfusion MR imaging on the acute ischemic cerebral infarction patients through this study. We compared 22 patients who were done with DSC imaging and ASL imaging in admitted emergency room with acute ischemic cerebral infarction, with 36 normal comparison persons (DSC image on 21persons, ASL images on 15persons). Siemens Magnetom Verio 3.0T with 12 channel head coil was used for this study. DSC image obtained 4 maps(rCBV, rCBF, rMTT, TTP) through post-processing. For qualitative analysis we compared the area of lesion macro-diagonal with the size of diffusion weighted MR image for rMTT, TTP, rCBF, rCBV, ASL maps. For Quantitative analysis we analyzed significant correlations between less than 3 cm infarction group and normal comparison group using mean relative value of flowing image with Mann-Whitney U test. TTP(95.5%) and rCBF(95.5%) maps showed high recognition rate in qualitative analysis for >3cm infarction group. The rCBF and rCBV map tests were highly related with final stage stroke areas. Mean relative value of infarction group showed a significant correlations in quantitative analysis(p<0.05). As a conclusion, arterial spin labeling image showed high lesion recognition rate in the >3cm infarction group. Mean relative values in quantitative evaluation were used for reference data. If we do more sustainable researches, ASL image will be useful for an early diagnosis of cerebral infarction, determination of the range of ischemic pneumbra and effective treatments.