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Updated: Feb 14, 2026
Magnetic Resonance Imaging Quantification of Pulmonary Perfusion using Calibrated Arterial Spin Labeling
Published on: May 30, 2011
Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI
Giovanni Morana1, Domenico Tortora2, Serena Staglianò3
1Neuroradiology Unit, Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147, Genoa, Italy. giovannimorana@gaslini.org.
Purpose:
The aim of this study was to compare arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) MRI perfusion with respect to diagnostic performance in tumor grading in pediatric patients with low- and high-grade astrocytic tumors (AT).
Methods:
We retrospectively analyzed 37 children with histologically proven treatment naive low- and high-grade AT who underwent concomitant pre-operative ASL and DSC MRI perfusion. Studies were performed on a 1.5 T scanner, and a pulsed technique was used for ASL. DSC data were post-processed with a leakage correction software. Normalization of tumor perfusion parameters was performed with contralateral normal appearing gray matter. Normalized cerebral blood volume (nCBV) values in the most perfused area of each neoplasm were compared with normalized DSC-derived cerebral blood flow (nDSC-CBF) and ASL-derived cerebral blood flow (nASL-CBF) data, and correlated with WHO tumor grade. Statistics included Pearson's chi-square and Mann-Whitney U tests, Spearman's rank correlation, and receiver operating characteristic (ROC) analysis.
Results:
A significant correlation was demonstrated between DSC and ASL data (p < 0.001). Significant differences in terms of DSC and ASL data were found between low- and high-grade AT (p < 0.001). ROC analysis demonstrated similar performances between all parameters in predicting tumor grade (nCBV: AUC 0.96, p < 0.001; nDSC-CBF: AUC 0.98, p < 0.001; nASL-CBF: AUC 0.96, p < 0.001).
Conclusions:
Normalized pulsed ASL performed with a 1.5 T scanner provides comparable results to DSC MRI perfusion in pediatric AT and may allow distinction between high- and low-grade AT.
Insights
Arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) MRI perfusion show similar diagnostic performance for grading pediatric astrocytic tumors (AT). Both methods effectively differentiate low-grade from high-grade AT, offering valuable insights for treatment decisions.
Area of Science:
- Neuroimaging
- Pediatric Oncology
- Radiology
Background:
- Accurate grading of pediatric astrocytic tumors (AT) is crucial for treatment planning and prognosis.
- Arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) MRI are advanced perfusion imaging techniques.
- Comparing the diagnostic performance of ASL and DSC MRI in pediatric AT grading is essential for optimizing clinical practice.
Purpose of the Study:
- To compare the diagnostic performance of ASL and DSC MRI perfusion for tumor grading in pediatric patients with low- and high-grade astrocytic tumors (AT).
- To evaluate the ability of normalized cerebral blood volume (nCBV), normalized DSC-derived cerebral blood flow (nDSC-CBF), and ASL-derived cerebral blood flow (nASL-CBF) to differentiate tumor grades.
Main Methods:
- Retrospective analysis of 37 treatment-naive pediatric patients with histologically proven AT who underwent pre-operative ASL and DSC MRI on a 1.5 T scanner.
- Pulsed ASL technique and DSC with leakage correction software were utilized; perfusion parameters were normalized to contralateral gray matter.
- Statistical analyses included correlation, group comparisons (Mann-Whitney U), and receiver operating characteristic (ROC) analysis to assess diagnostic performance for tumor grading.
Main Results:
- A significant correlation was observed between DSC and ASL perfusion data (p < 0.001).
- Significant differences in both DSC and ASL perfusion parameters were found between low- and high-grade AT (p < 0.001).
- ROC analysis revealed similar high performances for nCBV (AUC 0.96), nDSC-CBF (AUC 0.98), and nASL-CBF (AUC 0.96) in predicting tumor grade.
Conclusions:
- Normalized pulsed ASL at 1.5 T provides diagnostic performance comparable to DSC MRI perfusion for grading pediatric astrocytic tumors.
- Both ASL and DSC MRI perfusion techniques are effective in distinguishing between low- and high-grade AT in pediatric patients.
- ASL MRI represents a viable alternative to DSC MRI for assessing perfusion and grading pediatric AT.
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