Quantification of cerebral perfusion using the "bookend technique": an evaluation in CNS tumors

Timothy J. Carroll*, Sandra Horowitz, Wanyong Shin, Jessy Mouannes, Rahul Sawlani, Saad Ali, Jeffrey Raizer, Stephen Futterer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


We present a method of quantifying cerebral blood volume using dynamic susceptibility contrast. Our approach combines T2-weighted echo planar imaging (EPI) pulse sequences and reference scans that determine the parenchymal T1 changes resulting from an injection of a gadolinium chelate. This combined T2- and T1-weighted approach (the "bookend" technique) has been shown to be effective in the quantification of gradient-echo (GRE) (T2*-weighted) perfusion images but has not been applied to spin-echo EPI (SE-EPI) (T2-weighted) images. The physics related to blood volume measurement based on T2- and T2*-weighted EPI sequences is known to be different, and there is a question as to whether the bookend approach is effective with SE-EPI. We have compared the quantitative SE-EPI with GRE-EPI in a series of patients with central nervous system (CNS) tumors. We found that quantitative cerebral blood volume (qCBV) values for SE-EPI and GRE-EPI are in agreement with each other and with historical reference values. A subjective evaluation of image quality showed that image quality in the SE-EPI scans was high and exhibited high interreader agreement. We conclude that measuring qCBV using the bookend technique with SE-EPI images is possible and may be a viable alternative to GRE-EPI in the evaluation of CNS tumors.

Original languageEnglish (US)
Pages (from-to)1352-1359
Number of pages8
JournalMagnetic Resonance Imaging
Issue number10
StatePublished - Dec 2008


  • Cancer
  • Human
  • Patients
  • Perfusion
  • Quantification
  • Spin-echo

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Biomedical Engineering


Dive into the research topics of 'Quantification of cerebral perfusion using the "bookend technique": an evaluation in CNS tumors'. Together they form a unique fingerprint.

Cite this