A fully automated method for quantitative cerebral hemodynamic analysis using DSC-MRI.

Dynamic susceptibility contrast (DSC)-based perfusion analysis from MR images has become an established method for analysis of cerebral blood volume (CBV) in glioma patients. To date, little emphasis has, however, been placed on quantitative perfusion analysis of these patients, mainly due to the associated increased technical complexity and lack of sufficient stability in a clinical setting. The aim of our study was to develop a fully automated analysis framework for quantitative DSC-based perfusion analysis. The method presented here generates quantitative hemodynamic maps without user interaction, combined with automatic segmentation of normal-appearing cerebral tissue. Validation of 101 patients with confirmed glioma after surgery gave mean values for CBF, CBV, and MTT, extracted automatically from normal-appearing whole-brain white and gray matter, in good agreement with literature values. The measured age- and gender-related variations in the same parameters were also in agreement with those in the literature. Several established analysis methods were compared and the resulting perfusion metrics depended significantly on method and parameter choice. In conclusion, we present an accurate, fast, and automatic quantitative perfusion analysis method where all analysis steps are based on raw DSC data only.