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The authors' hypothesis is that incorporating bidirectional contrast agent transport into the DSC MR imaging signal model will improve rCBV estimates in brain tumors. A unidirectional contrast agent extravasation model (Boxerman-Weisskoff) was compared with a bidirectional contrast agent exchange model. For both models, they compared the goodness of fit with the parent leakage-contaminated relaxation rate curves and the difference between modeled interstitial relaxation rate curves and dynamic contrast-enhanced MR imaging in 21 patients with glioblastoma. The authors conclude that the bidirectional model more accurately corrects for the T1 or T2* enhancement arising from contrast agent extravasation due to blood-brain barrier disruption in high-grade gliomas by incorporating interstitial washout rates into the DSC MR imaging relaxation rate model.

Bookend perfusion was used to quantify parameters in normal-appearing and lesional tissue at different relapsing-remitting MS stages in 39 patients and 19 age-matched healthy controls. Perfusion parameters such as CBF, CBV, and MTT were compared along with cognitive performance. White matter lesion but not cortical lesion perfusion was significantly reduced in cognitively impaired patients with relapsing-remitting MS versus unimpaired patients with relapsing-remitting MS. Perfusion reduction with disease progression was greater in normal-appearing gray matter and normal-appearing white matter compared with cortical lesions and white matter lesions. The authors conclude that the greatest changes are present within NAGM and NAWM, necessitating absolute rather than relative lesion perfusion measurement.

The authors explored the effect of multimodal imaging (CT perfusion and/or CT angiography) versus noncontrast CT alone on time to treatment and outcomes in the IMS III trial. Of 656 subjects enrolled in the trial, 90 (13.7%) received CTP and CTA, 216 (32.9%) received CTA (without CTP), and 342 (52.1%) received NCCT alone. Median times from stroke onset to IV tPA in the CTP+CTA, CTA, and NCCT groups were 120.5 vs 117.5 vs 120 minutes, respectively. They conclude that the use of CTA (with or without CTP) did not delay IV tPA or endovascular therapy compared with NCCT in the IMS III trial.