Why MRI Perfusion is Important when Evaluating Brain Tumors With Dr. Leland Hu, MD

Zone3podcast is joined in studio by a renowned Neuro-Radiologist Dr. Leland Hu. Dr. Hu grew up in Dallas Texas where he attended Med School and did his residency. He did his fellowship at Barrow Neurological Institute. 

For the past 15 years, Dr. Hu has been with the Mayo Clinic. Dr. Hu has a passion for neuro-imaging with a special interest in perfusion-weighted imaging. Perfusion Weighted Imaging(PWI) provides information about hemodynamic parameters such as cerebral blood volume, cerebral blood flow, and transit time (e.g., mean transit time, time to peak, time to peak of the residue function). 

In the acute setting, the combination of DWI and PWI is used to estimate potentially salvageable ischemic brain tissue by assessing the “mismatch” between the DWI and the hypoperfused lesion volume on PWI sequences. PWI determines if other vascular territories with no DWI abnormality are also at risk of infarction, allowing for expedited medical management.  After arterial recanalization, regions of cerebral hyperperfusion may be seen. In the subacute and chronic phase, PWI can be useful in providing information about areas of reduced perfusion (oligemic or ischemic brain tissue) in conditions like severe carotid artery stenosis, moyamoya disease (MMD), or other arterial occlusive diseases. 

Perfusion technique allows Radiologists to decipher tumor vs. post-treatment effect. PWI is a very effective tool in terms of treating Gliomas, specifically Glioblastomas as they are the most common. We really appreciate Dr. Hu for sitting with us and helping to provide insight for those looking to advance their knowledge of imaging/treatment.