Perfusion and Time of Exchange Measurements in IDH Mutational Subgroups of Gliomas Using BBB-ASL

Motivation: Unlike contrast-enhanced T1-weighted MRI, which may overlook subtle blood-brain barrier (BBB) integrity changes, the blood-brain barrier arterial spin labeling (BBB-ASL) technique offers a novel non-invasive method to assess BBB disruptions. Goal(s): To analyze the cerebral blood flow (CBF) and exchange time (Tex) differences between the isocitrate dehydrogenase (IDH) mutational subgroups of gliomas using BBB-ASL. Approach: Tex and CBF maps of 25 gliomas were estimated using a region-specific T2-correction within the BBB-ASL model and were compared using a Mann-Whitney U test. Results: IDH-wildtype tumors had significantly higher perfusion than IDH-mutant tumors. Although exchange times were lower in IDH-wildtype tumors, this difference was not significant. Impact: Our findings underscore the promising potential of multi-echo BBB-ASL in evaluating BBB integrity and identifying IDH mutational subgroups of gliomas.