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  • 1
    Keywords: brain ; measurement ; radiotherapy ; tumor ; BLOOD ; Germany ; PERFUSION ; THERAPY ; FOLLOW-UP ; follow-up studies ; imaging ; QUANTIFICATION ; VOLUME ; TISSUE ; NUCLEAR-MEDICINE ; radiation ; PATIENT ; BLOOD-FLOW ; blood flow ; FLOW ; MRI ; SEQUENCE ; treatment ; stereotactic ; radiosurgery ; STEREOTACTIC RADIOSURGERY ; DECREASE ; metastases ; CEREBRAL-BLOOD-FLOW ; PREDICTION ; NORMAL TISSUE ; nuclear medicine ; brain metastases ; GLIOMAS ; LOBE EPILEPSY ; QUIPSS-II ; radiology ; RE ; THERAPIES ; IMAGING TECHNIQUES ; TUMOR VOLUME ; ARTERIAL ; neoplasm metastasis ; relative regional cerebral blood flow ; VOLUME MAPS
    Abstract: Rationale and Objectives: To assess if preradiation and early follow-up measurements of relative regional cerebral blood flow (rrCBF) can predict treatment outcome in patients with cerebral metastases and to evaluate rrCBF changes in tumor and normal tissue after stereotactic radiosurgery using arterial spin-labeling (ASL) and first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MRI. Methods: In 25 patients with a total of 28 brain metastases, DSC MRI and ASL perfusion MRI using the Q2TIPS sequence were performed with a 1.5-T unit. Measurements were performed prior to and at 6 weeks. 12 weeks, and 24 weeks after stereotactic radiosurgery. Follow-up examinations were completely available in 25 patients for Q2TIPS and 17 patients with 18 metastases for DSC MRI. The rrCBF of the metastases and the normal brain tissue was determined by a region-of-interest analysis. rrCBF values were correlated with the treatment outcome that was classified according to tumor volume changes at 6 months. Results: The alteration of the rrCBF at the 6-week follow-up was highly predictive for treatment outcome. A decrease of the rrCBF value predicted tumor response correctly in all metastases for Q2TIPS and in 13 of 16 metastases for DSC MRI. The pretherapeutic rrCBF was not able to predict treatment outcome. The rrCBF values in normal brain tissue affected by radiation doses less than 0.5 Gy remained unchanged after therapy. Conclusion: These preliminary results suggest that ASL and DSC MRI techniques determining rrCBF changes in brain metastases after stereotactic radiosurgery allow the prediction of treatment outcome
    Type of Publication: Journal article published
    PubMed ID: 15087722
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  • 2
    Keywords: brain ; Germany ; MODEL ; MODELS ; PERFUSION ; imaging ; SYSTEM ; CONTRAST ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; NERVOUS-SYSTEM ; CEREBRAL-BLOOD-FLOW ; CENTRAL-NERVOUS-SYSTEM ; CONTRAST-ENHANCED MRI ; functional MRI ; ENHANCEMENT ; INVERSION ; ARTERIAL ; contrast-enhanced ; functional imaging ; ARTERIAL WATER ; ASL ; BALLOON MODEL ; BOLD-fMRI ; BRAIN PERFUSION ; dynamic contrast enhanced-MRI ; dynamic susceptibility contrast-MRI ; FMRI ; HIGH-SPATIAL-RESOLUTION ; OXYGEN-CONSUMPTION ; QUIPSS II
    Abstract: This review presents the basic principles of functional imaging of the central nervous system utilizing magnetic resonance imaging. The focus is set on visualization of different functional aspects of the brain and related pathologies. Additionally, clinical cases are presented to illustrate the applications of functional imaging techniques in the clinical setting. The relevant physics and physiology of contrast-enhanced and non-contrast-enhanced methods are discussed. The two main functional MR techniques requiring contrast-enhancement are dynamic T1 - and T2(*)-MRI to image perfusion. Based on different pharmacokinetic models of contrast enhancement diagnostic applications for neurology and radio-oncology are discussed. The functional non-contrast enhanced imaging techniques are based on "blood oxygenation level dependent (BOLD)-fMRI and arterial spin labeling (ASL) technique. They have gained clinical impact particularly in the fields of psychiatry and neurosurgery
    Type of Publication: Journal article published
    PubMed ID: 15871087
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  • 3
    Keywords: brain ; IRRADIATION ; BLOOD ; Germany ; PERFUSION ; THERAPY ; FOLLOW-UP ; imaging ; QUANTIFICATION ; TISSUE ; TUMORS ; TIME ; PATIENT ; BLOOD-FLOW ; blood flow ; FLOW ; MRI ; SEQUENCE ; SEQUENCES ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; stereotactic ; radiosurgery ; STEREOTACTIC RADIOSURGERY ; metastases ; POSITRON-EMISSION-TOMOGRAPHY ; EPI ; CEREBRAL-BLOOD-FLOW ; WHITE-MATTER ; GADOPENTETATE DIMEGLUMINE ; FAIR ; brain metastases ; BOLUS ; HYPOPERFUSION ; LOBE EPILEPSY ; cerebral MR perfusion imaging,arterial spin-labeling,dynamic susceptibility-weighted contrast-enhanc ; QUIPSS-II ; VARIANCE
    Abstract: Objectives: To evaluate relative cerebral blood flow (rCBF) in normal brain tissue using arterial spin-labeling (ASL) methods and first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) magnetic resonance imaging (MRI).Methods: Sixty-two patients with brain metastases were examined on a 1.5 T-system up to 6 times during routine follow-up after stereotactic radiosurgery. Perfusion values in normal gray and white matter were measured using the ASL techniques ITS-FAIR in 38 patients, Q2TIPS in 62 patients, and the first-pass DSC echo-planar (EPI) MRI after bolus administration of gadopentetate dimeglumine in 42 patients. Precision of the ASL sequences was tested in follow-up examinations in 10 healthy volunteers.Results: Perfusion values in normal brain tissue obtained by all sequences correlated well by calculating Pearson's correlation coefficients (P 〈 0.0001) and remained unchanged after stereotactic radiosurgery as shown by analysis of variance (P 〉 0.05).Conclusion: Both ASL and DSC EPI MRI yield highly comparable perfusion values in normal brain tissue
    Type of Publication: Journal article published
    PubMed ID: 14566181
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