Dynamic Susceptibility Contrast MRI in Gliomas: What the Radiologist Needs to Know

Sameeha Fallatah, Xavier Golay, Rolf Jäger, Sotirios Bisdas


Perfusion MRI analyses tissues’ temporal responses to the inflowing exogenous contrast agents or labeled blood to characterize the hemodynamics properties of the tissues. Perfusion MRI techniques are sensitive to microvasculature, thus, can be a robust tool to study brain tumors where the neovascularization is a hallmark of malignancy. The derived indices can be helpful in many aspects, including tumor grading, prediction of malignant transformation, patient management planning, and monitoring treatment responses. A major MRI perfusion approach using exogenous contrast agent is dynamic susceptibility contrast MRI (DSC-MRI). With the increasing need for perfusion MR imaging in clinical practice, it is important to understand the basic principles of the technique and its meaningful clinical applications. In this review, we discuss the most commonly used perfusion sequence, DSC-MRI. We provide a comprehensive overview of the principles for clinical neuroradiologists and neuroscientists to help improve their understanding of the underlying theory and the technical aspects of DSC-MRI, as well as image acquisition, image analysis, its possible pitfalls, and its clinical applications in tumor imaging.

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