Automated injection improves consistency of brain perfusion parameters in dynamic susceptibility contrast magnetic resonance imaging in dogs in a randomized trial.

Automated contrast injection improves DSC MRI perfusion reproducibility; manual injection requires method-specific reference parameters for accurate interpretation.

This prospective randomized trial compared dynamic susceptibility contrast (DSC) MRI perfusion parameters in morphologically normal canine brains following manual versus automated contrast medium injection at a 3-tesla field strength. Twenty-nine client-owned dogs were enrolled and randomly allocated to manual (n=16) or automated (n=13) injection of gadoteric acid (0.1 mmol/kg) at weight-dependent rates. Perfusion parameters assessed included time of contrast arrival (T0), time to peak enhancement (TTP), mean transit time (MTT), relative cerebral blood flow (relCBF), and relative cerebral blood volume (relCBV) across three regions of interest: thalamus, piriform lobe, and semioval center. Manual injection consistently produced longer T0, TTP, and MTT across all regions, along with higher relCBV in the semioval center and lower relCBF in the thalamus and piriform lobe compared to automated injection. Visually, manual injection generated flatter, broader perfusion curves, reflecting slower and less uniform bolus delivery. Automated injection yielded superior reproducibility and more consistent DSC curves, likely due to standardized delivery rates. Despite these differences, manual injection remains clinically feasible. However, clinicians must recognize that manual injection produces characteristically different baseline perfusion parameters and should apply injection-method-specific reference values when interpreting DSC studies for brain pathology. This study provides the first randomized comparative data on injection technique and DSC perfusion in dogs, offering important guidance for neuroimaging protocol standardization in veterinary medicine.

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