Multi-delay arterial spin labelling and conventional single-delay arterial spin labelling perfusion in nasopharyngeal carcinoma: correlation with dynamic contrast enhanced MR imaging

Abstract

Objective: The purpose of this prospective study was to investigate the potential correlation between three perfusion methods:multi-delay arterial spin labeling (MDASL),conventional single-delay arterial spin labelling(SDASL), and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in patients with locoregionally advanced nasopharyngeal carcinoma (ANPC). Materials and Methods: Forty-seven patients with locoregionally ANPC were prospectively recruited.MDASL parameters including the corrected tumor blood flow (c-TBF), arterial transit time (ATT), and associated tumor blood volume (aTBV),SDASL including the non-corrected tumor blood flow (nc-TBF), DCE-MRI quantitative parameters including Ktrans, Kep, Ve, Vp were calculated by two observers independently. The intra- and inter-observer agreement was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Relationships between MDASL, SDASL and DCE-MRI parameters were assessed using Spearman’s rank correlation. Results: The intra- and interobserver reproducibility were observed to be excellent, with an ICC ranging from 0.81 to 0.997 and a narrow width of 95% limits of agreement. A good positive correlation was observed between MDASL-related perfusion parameters (c-TBF, aTBV) and DCE-MRI parameters (Ktrans, Kep) (Spearman’s rank correlation coefficients: 0.61 to 0.71, p < 0.001). Additionally, a slight correlation was noted between ATT values from MDASL and Ve perfusion parameters from the DCE-MRI (r=0.23,P=0.005). SDASL (nc-TBF) values showed a strong or moderate correlation with Ktrans(p<0.001,r = 0.59) and Kep (p<0.001, r=0.64), respectively. No correlation was observed between MDASL-related perfusion parameters (c-TBF and aTBV), SDASL (nc-TBF) and DCE parameters (Ve and Vp) (Spearman’s rank correlation coefficients: 0.07 to 0.145, p > 0.05). Conclusion: MDASL multi-parametric perfusion,SDASL single-parameter perfusion and quantitative DCE-MRI parameters were correlated in the assessment of ANPC and were both reliable and reproducible.Although SDASL demonstrated a strong correlation with DCE-MRI, the correlation was slightly inferior to that of MDASL multi-parameters.MDASL, as a promising noninvasive perfusion imaging tool, may become an alternative to DCE-MRI for assessing ANPC perfusion levels in the future.