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Magnetic Resonance Imaging Quantification of Pulmonary Perfusion using Calibrated Arterial Spin Labeling

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An Appeal to Standardize CT- and MR-Perfusion.

B Turowski¹, P Schramm²

¹Department of Diagnostic and Interventional Radiology, University Dusseldorf, 40225, Dusseldorf, Germany. bernd.turowski@uni-duesseldorf.de.

Clinical Neuroradiology

|August 21, 2015

Summary

Accurate risk assessment in cerebrovascular diseases is challenging due to a lack of reliable perfusion imaging thresholds. Current multiparametric protocols need standardized calibration for effective clinical application in stroke and neurovascular conditions.

Keywords:

Brain CT-Perfusion MR-Perfusion Standardization

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Area of Science:

Neuroradiology
Cerebrovascular Diseases
Medical Imaging

Background:

Risk assessment and treatment decisions in cerebrovascular diseases present significant challenges in diagnostic and interventional neuroradiology.
Acute ischemic stroke necessitates rapid identification of infarction extent and at-risk tissue.
Estimating collateral flow in subacute delayed cerebral ischemia and chronic neurovascular diseases is complex.

Purpose of the Study:

To highlight the challenges in establishing reliable quantitative perfusion measurement thresholds for cerebrovascular diseases.
To discuss the limitations of current multiparametric perfusion imaging protocols.
To explain the technical and algorithmic issues impeding the broad clinical use of perfusion imaging.

Main Methods:

Review of multiparametric perfusion imaging protocols in acute ischemic stroke.
Analysis of challenges in estimating collateral flow for delayed cerebral ischemia and chronic occlusive diseases.
Discussion of the lack of standardized calibration and algorithms for quantitative perfusion measurements.

Main Results:

No established, reliable thresholds exist for determining tissue risk in various cerebrovascular conditions (acute, subacute, chronic).
Current perfusion imaging protocols suffer from varied parameter settings, diverse algorithms, and inconsistent normal/pathologic values.
Technical and algorithmic complexities hinder the widespread clinical application of perfusion imaging for many neurovascular issues.

Conclusions:

The lack of standardized, quantitative perfusion measurements and reliable thresholds impedes effective risk assessment and treatment decisions in cerebrovascular diseases.
Further research is needed to develop calibrated instruments and standardized algorithms for reproducible perfusion parameter measurements.
Addressing these technical and methodological issues is crucial for advancing the clinical utility of perfusion imaging in neuroradiology.