MR perfusion imaging

Perfusion imaging is a powerful tool in the imaging of brain tumors, improving differential diagnostics, tumor grading, and the planning and monitoring of different therapy modalities. Several technical approaches are available to characterize tumor perfusion; these methods are widely available, easy to apply, and the results provide essential additional information on brain tumor pathophysiology. This chapter provides a review of different perfusion measurement techniques with exogenous or endogenous tracers. The clinical application of perfusion measurements in neuro-oncological imaging is discussed in view of the pathophysiological background. The practical use of perfusion imaging in differential diagnosis and tumor grading is presented with regard to the prognostic value of the method. Applications in biopsy targeting and therapy planning are also discussed. In the last section of this chapter, advantages and limitations of perfusion imaging in the follow-up of brain tumors are summarized.