The 39 steps: evading error and deciphering the secrets for accurate dynamic susceptibility contrast MRI

Area of Science:

• Medical Imaging
• Neuroscience
• Radiology

Background:

• Dynamic susceptibility contrast (DSC) MRI is a standard clinical technique for evaluating cerebral perfusion and hemodynamic parameters.
• Despite its widespread use, accurate perfusion quantification remains challenging due to various technical and analytical issues.

Purpose of the Study:

• To provide a comprehensive guide to DSC-MRI, covering theoretical principles, practical considerations, and recent advancements.
• To address the challenges in DSC-MRI quantification by detailing 39 critical steps from data acquisition to interpretation.

Main Methods:

• The review systematically outlines 39 steps involved in the DSC-MRI workflow.
• Key areas covered include contrast agent properties, data acquisition, pre-processing, arterial input function determination, deconvolution techniques, and parameter calculation.

Main Results:

• The review identifies and explains potential problems, limitations, and latest advances across the entire DSC-MRI process.
• It discusses issues related to contrast agent dynamics, data analysis, and the distinction between absolute and relative quantification.

Conclusions:

• This structured approach aims to enhance the accuracy and reliability of DSC-MRI perfusion quantification.
• The comprehensive guide facilitates better understanding and application of DSC-MRI in clinical and research settings.