We chose to research this topic because it seemed like there had been quite a few papers suggesting that perfusion MR imaging characteristics are associated with glial tumor grade, and even that perfusion MR imaging findings can help predict recurrence and survival in patients with glial tumors. But we had not seen any studies of perfusion MR imaging as a clinical tool that might be helpful in the management of patients with glial tumors, and this was the most obvious setting where we thought this new imaging might prove useful in clinical practice.

For years, perfusion MR imaging has been a technique used primarily in research. Because our study suggested that perfusion MR imaging has an effect on clinical management decisions in patients with glial tumors (ie, there is evidence for level 4 efficacy), we think our findings may help move perfusion MR imaging into more widespread clinical use.

In our practice we now image all patients with glial (or intracranial metastatic) tumors using a brain tumor MR protocol that always includes either DSC (with DCE now), ASL, or both. Given the findings from our study,

we can justify the additional sequences in clinical practice, because we now have data to support our rationale—namely, that the perfusion imaging provides unique diagnostic information that is useful in the clinical care of these patients.

Some providers within our own network have provided very positive feedback on the publication (our institution’s media folks do a great job of sharing highlights of faculty’s research). Also, we have actually had some patients, who seemed to have read about our work with brain tumor imaging in the lay press, ask us specifically about our advanced brain MRI.

We are beginning a project to investigate whether perfusion MR imaging has an effect on the clinical management of patients with brain metastases. We are using a similar prospective study design to the one we used for the glial tumor study.

We hope to present findings of the new study at the ASNR annual meeting next spring.

 

Read this article at AJNR.org . . .