NIMG-78. USE OF ARTERIAL SPIN LABELING TO DETECT METASTASIS OF MENINGEAL SOLITARY FIBROUS TUMORS

Abstract

Abstract Meningeal solitary fibrous tumors (SFT), formerly known as hemangiopericytoma, are rare, highly vascular, mesenchymal dural based neoplasms. Meningeal SFT require lifelong imaging surveillance given high risk of recurrence and metastasis, even decades after initial diagnosis. Often these metastases are initially small, nodular dural masses that are difficult to detect with standard brain tumor imaging protocols. Given SFT are highly vascular tumors, we hypothesized that recurrent meningeal SFT would have elevated cerebral blood flow using Arterial Spin Labeling (ASL) perfusion imaging. ASL is a noninvasive MRI technique used to detect cerebral blood flow in high grade neoplasms and hyper vascular meningiomas without intravenous contrast. We evaluated ASL in two patients with recurrent meningeal SFT. In both patients the recurrent meningeal SFT demonstrated elevated perfusion by ASL. In one patient, the elevated ASL signature enabled identification of a small metastasis that was not initially appreciated on structural imaging. Following treatment with antiangiogenic therapy, ASL was no longer elevated while enhancement did not change. To our knowledge, this is the first study reporting utility of ASL imaging in detecting intracranial recurrence of meningeal SFT. We propose further study of sensitivity of ASL to detect recurrent meningeal SFT.