Perfusion imaging in brain tumours

Perfusion-weighted magnetic resonance imaging (MRI) is a widely used technique to study the blood perfusion to brain tumours. It provides information on tissue hemodynamic changes and increases the accuracy of anatomical MRI in the diagnosis of brain tumours. Numerous perfusion MRI techniques have been devised to measure various perfusion-related parameters in the last 30 years. There are two primary perfusion MRI approaches those with exogenous contrast agent including dynamic susceptibility contrast MRI (DSC-MRI) and dynamic contrast enhanced MRI (DCE-MRI); and those without exogenous contrast agent, including arterial spin labelling (ASL). Despite the substantial development of perfusion MRI, the technique still encounters significant challenges. Many limitations and drawbacks have been already pointed out in the literature, yet more work remains to be done to address these limitations. A major issue with these techniques is the lack of technical standardisation in acquisition and post-processing methods. Furthermore, high-quality images cannot be achieved without attention to quality control. This thesis focuses on perfusion MRI in brain tumours with a great deal of attention to reproducibility, quality control and standardisation