Characterization of Skull Base Lesions Using Pseudo-Continuous Arterial Spin Labeling.

Area of Science:

• Neuroradiology
• Medical Imaging
• Oncology

Background:

• Skull base lesions present diagnostic challenges.
• Non-invasive perfusion assessment is crucial for characterization.
• Pseudo-continuous arterial spin labeling (pCASL) is an advanced MRI technique.

Purpose of the Study:

• To evaluate the diagnostic performance of pCASL in assessing skull base lesions.
• To differentiate between hypervascular and non-hypervascular lesions.
• To establish quantitative cut-off values for specific lesion identification.

Main Methods:

• Retrospective analysis of 99 patients with histopathologically confirmed skull base lesions.
• Inclusion of pCASL and 3D T1-weighted post-contrast MRI sequences.
• Qualitative assessment and quantitative measurement of normalized tumor blood flow (nTBF).

Main Results:

• pCASL achieved 98% accuracy in lesion classification.
• Significant differences in nTBF were observed between hypervascular and non-hypervascular lesions (p < 0.001).
• Distinct nTBF cut-off values were identified for differentiating specific lesions like meningioma, schwannoma, adenoma, paraganglioma, and metastases.

Conclusions:

• pCASL demonstrates high diagnostic performance for skull base lesion characterization.
• Both visual assessment and nTBF quantification are effective.
• Incorporating pCASL into standard protocols is recommended for improved assessment.