Perfusion study of brain neoplasms without the administration of contrast agent obtainable with the pCASL sequence can be a valid alternative to the most widely used study technique that is DSCE and which provides the administration of GD contrast medium.
In our experience we have been able to evaluate how in case of pathological increase of the perfusion indices,
there is a good overlap of the values deriving from the chromatic maps obtained with the technique without contrast medium pCASL and the chromatic maps obtained with the study technique with administration of contrast medium DSCE.
This result is of considerable importance as it has been achieved through two methods that are based on completely different physical assumptions: in fact pCASL in based on the detection of the signal deriving fron labeled spins incoming in the layer under examination while the DSCE is based on the signal drop determined by the MDC after Gd administeredon the first passage in the district in question.
The results achieved by our study are still in agreement with articles in the literature,
important difference is that most of the currently available articles describe studies carried out with neuro-radiologically "high field" scanners 3 Tesla.
The novelty of our experience consists in the fact that the study was carried out with a "low field" scanner,
that is,
1.5 Tesla,
albeit of the latest generation.
Our initiative,
although limited by being monocentric and with a reduced number of cases,
is not without scientific basis,
in fact recent articles of literature,
while recognizing that by carrying out pCASL sequence with high field,
better results are obtained in relation to the higher signal/noise ratio and acquisition timing,
this therefore does not mean the sequence can not be used with 1.5 Tesla scanners,
also due to the fact that the manufacturers now offer it in the neuroradiological functional imaging package.
Of course it is to be confirmed,
as established in the literature,
that with the low field it is lost both in terms of signal/noise ratio and in terms of temporal resolution.
The good results obtained in our experience want to be an incentive to use this sequence even with 1.5 tesla devices,
for the simple reason that they are still widely more widespread in the territory as the 3 tesla devices in addition have a greater cost of purchase and maintenance,
until some time ago the installation was authorized for research reasons.
In addition to support the use of the sequence object of our study there are the latest more restrictive provisions relating to the use of the contrast medium after the discovery of its deposit at the level of the basal ganglia.