Brain tumor perfusion: comparison of dynamic contrast enhanced magnetic resonance imaging using T1, T2, and T2* contrast, pulsed arterial spin labeling, and H2(15)O positron emission tomography

Eur J Radiol. 2009 Jun;70(3):465-74. doi: 10.1016/j.ejrad.2008.02.012. Epub 2008 Mar 24.


Objectives: Different techniques for measuring of perfusion are clinically available, but these are usually applied to healthy brain tissue.

Material and methods: Five different techniques were used here in 12 patients with brain tumors to investigate the impact of tumor vascularization on the perfusion signal: three qualitative dynamic contrast-enhanced/susceptibility-contrast magnetic resonance imaging (DCE-MRI/DSC-MRI) techniques exploiting T(1), T(2), T(2)(*) contrast, and two quantitative techniques, pulsed arterial spin labeling (PASL) and H(2)(15)O positron emission tomography (H(2)(15)O-PET).

Results: In a first approximation, a linear correlation was found between all five imaging modalities regarding the perfusion signal of both, normal brain tissue and tumor. The estimated values for tumor perfusion differed significantly between the techniques (1=methodical mean in arbitrary units): PASL: 0.83, H(2)(15)O-PET: 0.62, T(1)-DCE: 1.73, T(2)-DCE: 0.69, T(2)(*)-DSC: 0.89.

Conclusions: The tumor perfusion values, determined with different techniques are not comparable. The T(2)(*)-DSC, here applied with contrast agent presaturation of extravascular space, and PASL depict median perfusion most reliably.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / blood supply
  • Brain Neoplasms / diagnosis*
  • Contrast Media
  • Gadolinium DTPA*
  • Glioma / blood supply
  • Glioma / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / diagnosis*
  • Oxygen Isotopes*
  • Perfusion Imaging / methods*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spin Labels
  • Water
  • Young Adult


  • Contrast Media
  • Oxygen Isotopes
  • Radiopharmaceuticals
  • Spin Labels
  • Water
  • Gadolinium DTPA