Current Concepts in Perfusion and DCE MRI

October 15–17, 2009
University Hospital Freiburg
Freiburg, DE

Course Organisers:
Roland Bammer
Lucas Center, Stanford University
Department of Radiology, Stanford, CA/US

Valerij Kiselev
Department of Diagnostic Radiology Medical Physics
University Hospital Freiburg/DE

Local Organiser:
Valerij Kiselev
Department of Diagnostic Radiology Medical Physics
University Hospital Freiburg/DE

Mr. Kellner, University Hospital Freiburg/DE

Faculty:
Roland  Bammer, Valerij Kiselev, Peter  Gall, Rudolf  Stollberger, Geoff  Parker, Leif  Østergaard, Xavier  Golay, Matthias  Günther, Matus  Straka, Maarten  Lansberg, Mark  Parsons

Programme:
Please click here to download the programme of the course as PDF.

Course Description
This course is designed to provide deeper insight into the
biophysics of perfusion, the consequential requirements of
the data acquisition, and MR methodology for the qualitative
and quantitative data evaluation. After an overview and
introduction in the basics of physiology and the clinical role
of perfusion imaging, the general theory behind perfusion
quantification is explained. An overview of existing perfusion
imaging techniques (not only MR-based) is given.
An introduction to arterial spin labelling (ASL) techniques
and associated data processing strategies is presented, emphasising
the theory behind quantification approaches. The
differences in quantification of continuous and pulsed ASL
are discussed.
Perfusion MRI using contrast agents is split up into two parts:
Dynamic Contrast Enhanced perfusion imaging (DCE) and
dynamic susceptibility contrast (DSC) MRI. The differences
in tracer kinetics are explained and analysed. The theory of
relaxation enhancement induced by the contrast agent is
discussed.
As an integral part, the course will also include a substantial
amount of time that will be spent on exercises, which are intended
to enhance the understanding of basic and advanced
topics and will be performed under guidance of the lecturers.
The course is designed to provide a compact understanding
and a stable bases for scientists who intend to enhance their
knowledge with respect to perfusion-weighted MR imaging
or who wish to get involved in method development of perfusion
measurements.

Learning Objectives

Arterial Spin Labelling (ASL)
• Basic Principles of ASL
• Continuous versus pulsed ASL
• Implementation and labelling schemes (CASL, STAR,
PICORE, FAIR)
• Adiabatic inversion RF-pulses
• Quantification, QUIPSS, time-series, transit time
• Readout modules, 2D, 3D, multi-slice, background
suppression
• Other ASL techniques: Dynamic ASL,
Velocity selective ASL
• Artifacts, MT effect, saturation effects
• Vascular territory mapping
• Advantages and limitations at high field strength
• Applications within fMRI

Dynamic Contrast Enhanced Perfusion Imaging
(DCE-MRI)
• Basic principles & theory, effect of contrast agent,
T1 effects
• Contrast agent dynamics
• Quantification, pharmacokinetic modelling,
two-compartment modelling
• Physiologic parameters, permeability, blood
brain barrier
• Implementation & pulse sequences
• Applications (cerebral, abdominal)
• Advantages and limitations at high field strength

Dynamic Susceptibility Contrast Perfusion Imaging
(DSC-MRI)
• Basic principles & theory, effect of contrast agent,
T2, T2* effects
• Bolus tracking
• Quantification, arterial input function, deconvolution,
central volume theorem
• Cerebral perfusion, blood brain barrier, leakage,
CBF, CBV, MTT
• Myocardial perfusion, viability, delayed enhancement
• Applications (cerebral, abdominal)
• Advantages and limitations at high field strength

Theoretical aspects of DCE and DSC
• Importance of relaxation as a measure of
contrast agent concentration
• Host tissue dependence of the transverse tracer
relaxivity
• A brief introduction in theory of relaxation in
perfused tissue
• A critical overview of experimental methods
• Gradient echo or spin echo?
• Vessel size imaging
• Mathematics of deconvolution
• In-depth comparison of deconvolution methods
(SVD, cSVD, FFT)
• Filter transformations

Testdriving PWI software packages
• Rapid (Stanford)
• Freiburg software package
• ASSIST (Japan)