Perfusion Imaging: Physical Principles and Applications in the Brain

Perfusion Magnetic resonance imaging Magnetic resonance imaging (MRI) is able to characterize brain tumor biology and other central nervous system (CNS) disorders due to the underlying pathologic and physiologic changes that occur with tumor vasculature. In brain tumors, increases in vessel diameter, vessel wall thickness, and vessel number should lead to increased cerebral blood volume (CBV) measurements taken with dynamic susceptibility contrast (DSC) MRI. The degree of vascular proliferation is one of the most critical elements in the histopathologic characterization of tumor biology and determination of prognosis for several reasons. The most common methods for measurement of DSC-enhanced perfusion MRI (DSC MRI) metrics in brain tumors are the indicator dilution methods for non-diffusible tracers and the pharmacokinetic modeling approach developed by Tofts and Kermode. First-pass pharmacokinetic modelling is used to calculate vascular permeability from the same DSC MRI data used to calculate relative CBV. In 2000, World Health Organization revised the classification of CNS neoplasms.