Quantification of cerebral perfusion using the “bookend technique”: an evaluation in CNS tumors

Carroll, Timothy J.; Horowitz, Sandra; Shin, Wanyong; Mouannes, Jessy; Sawlani, Rahul; Ali, Saad; Raizer, Jeffrey; Futterer, Stephen

doi:10.1016/j.mri.2008.04.010

« Previous Next »Magnetic Resonance Imaging
Volume 26, Issue 10 , Pages 1352-1359, December 2008

Quantification of cerebral perfusion using the “bookend technique”: an evaluation in CNS tumors

Timothy J. Carroll
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Department of Radiology, Northwestern University, Chicago, IL, USA
- Corresponding author. Northwestern University, Department of Radiology, 676 N. St. Clair, Suite 1400, Chicago, IL 60611, USA. Tel.: +312 926 1733; fax: +312 695 4108.
Sandra Horowitz
- Department of Radiology, Northwestern University, Chicago, IL, USA
Wanyong Shin
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
Jessy Mouannes
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
Rahul Sawlani
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
Saad Ali
- Department of Radiology, Northwestern University, Chicago, IL, USA
Jeffrey Raizer
- Department of Neurology, Northwestern University, Chicago, IL, USA
Stephen Futterer
- Department of Radiology, Northwestern University, Chicago, IL, USA

Received 13 August 2007; received in revised form 7 April 2008; accepted 22 April 2008. published online 06 June 2008.

Abstract

We present a method of quantifying cerebral blood volume using dynamic susceptibility contrast. Our approach combines T₂-weighted echo planar imaging (EPI) pulse sequences and reference scans that determine the parenchymal T₁ changes resulting from an injection of a gadolinium chelate. This combined T₂- and T₁-weighted approach (the “bookend” technique) has been shown to be effective in the quantification of gradient-echo (GRE) (T₂*-weighted) perfusion images but has not been applied to spin-echo EPI (SE-EPI) (T₂-weighted) images. The physics related to blood volume measurement based on T₂- and T₂*-weighted EPI sequences is known to be different, and there is a question as to whether the bookend approach is effective with SE-EPI. We have compared the quantitative SE-EPI with GRE-EPI in a series of patients with central nervous system (CNS) tumors. We found that quantitative cerebral blood volume (qCBV) values for SE-EPI and GRE-EPI are in agreement with each other and with historical reference values. A subjective evaluation of image quality showed that image quality in the SE-EPI scans was high and exhibited high interreader agreement. We conclude that measuring qCBV using the bookend technique with SE-EPI images is possible and may be a viable alternative to GRE-EPI in the evaluation of CNS tumors.