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Feasibility of Arterial Spin Labeling Magnetic Resonance Imaging for Musculoskeletal Tumors with Optimized
Chien-Hung Lin1, Tsyh-Jyi Hsieh1,2, Yi-Chen Chou1
1Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan.
Abstract:
Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is used to perform perfusion imaging without administration of contrast media. However, the reliability of ASL for musculoskeletal tumors and the influence of post-labeling delay (PLD) have not been fully clarified. This study aimed to evaluate the performance of ASL with different PLDs in the imaging of musculoskeletal tumors. Forty-five patients were enrolled and were divided into a malignant group, a hypervascular benign group, a hypovascular benign group and a control group. The tissue blood flow (TBF) of the lesions and normal muscles was measured and the lesion-to-muscle TBF ratio and differences were calculated. The results showed that both the TBF of lesions and muscles increased as the PLD increased, and the TBF of muscles correlated significantly and positively with the TBF of lesions (all p < 0.05). The TBF and lesion-to-muscle TBF differences of the malignant lesions were significantly higher than those of the hypovascular benign lesions and the control group in all PLD groups (all p < 0.0125) and only those of the hypervascular benign lesions in the longest PLD (3025 ms) group (p = 0.0120, 0.0116). In conclusion, ASL detects high TBF in malignant tumors and hypervascular benign lesions, and a longer PLD is recommended for ASL to differentiate musculoskeletal tumors.
Insights
Arterial spin labeling (ASL) magnetic resonance imaging (MRI) can assess musculoskeletal tumors without contrast. Longer post-labeling delay (PLD) improves differentiation between malignant and benign lesions.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Arterial spin labeling (ASL) MRI offers contrast-free perfusion imaging.
- The reliability of ASL and the impact of post-labeling delay (PLD) in musculoskeletal tumors require further investigation.
Purpose of the Study:
- To evaluate the performance of ASL with varying PLDs for musculoskeletal tumor imaging.
- To assess the influence of PLD on tissue blood flow (TBF) measurements in different tumor types.
Main Methods:
- Forty-five patients with musculoskeletal tumors were categorized into malignant, hypervascular benign, hypovascular benign, and control groups.
- Tissue blood flow (TBF) was measured in lesions and normal muscles using ASL MRI across different PLDs.
- Lesion-to-muscle TBF ratios and differences were calculated.
Main Results:
- Both lesion and muscle TBF increased with longer PLDs, showing a significant positive correlation (p < 0.05).
- Malignant lesions exhibited significantly higher TBF and lesion-to-muscle TBF differences compared to hypovascular benign lesions and controls across all PLDs (p < 0.0125).
- Differences were also significant for hypervascular benign lesions at the longest PLD (3025 ms).
Conclusions:
- ASL MRI effectively identifies high TBF in malignant tumors and hypervascular benign lesions.
- A longer PLD is recommended for ASL MRI to enhance the differentiation of musculoskeletal tumors.
