K Leu1, J L Boxerman2, T F Cloughesy3, A Lai4, P L Nghiemphu4, L M Liau5, W B Pope6, B M Ellingson7. 1. From the UCLA Brain Tumor Imaging Laboratory (K.L., B.M.E.), Center for Computer Vision and Imaging Biomarkers Department of Bioengineering (K.L., B.M.E.), Henry Samueli School of Engineering and Applied Science Departments of Radiological Sciences (K.L., W.B.P., B.M.E.). 2. Department of Diagnostic Imaging (J.L.B.), Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island. 3. UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California. 4. UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California Neurology (A.L., P.L.N.). 5. Neurosurgery (L.M.L.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 6. Departments of Radiological Sciences (K.L., W.B.P., B.M.E.). 7. From the UCLA Brain Tumor Imaging Laboratory (K.L., B.M.E.), Center for Computer Vision and Imaging Biomarkers Department of Bioengineering (K.L., B.M.E.), Henry Samueli School of Engineering and Applied Science UCLA Neuro-Oncology Program (T.F.C., A.L., P.L.N., B.M.E.), University of California, Los Angeles, Los Angeles, California Departments of Radiological Sciences (K.L., W.B.P., B.M.E.) Biomedical Physics (B.M.E.) bellingson@mednet.ucla.edu.
Abstract
BACKGROUND AND PURPOSE: Contrast agent extravasation through a disrupted blood-brain barrier potentiates inaccurate DSC MR imaging estimation of relative CBV. We explored whether incorporation of an interstitial washout rate in a leakage-correction model for single-echo, gradient-echo DSC MR imaging improves relative CBV estimates in high-grade gliomas. MATERIALS AND METHODS: We modified the traditional model-based postprocessing leakage-correction algorithm, assuming unidirectional contrast agent extravasation (Boxerman-Weisskoff model) to account for bidirectional contrast agent exchange between intra- and extravascular spaces (bidirectional model). For both models, we compared the goodness of fit with the parent leakage-contaminated relaxation rate curves by using the Akaike Information Criterion and the difference between modeled interstitial relaxation rate curves and dynamic contrast-enhanced MR imaging by using Euclidean distance in 21 patients with glioblastoma multiforme. RESULTS: The bidirectional model had improved Akaike Information Criterion versus the bidirectional model in >50% of enhancing tumor voxels in all 21 glioblastoma multiformes (77% ± 9%; P < .0001) and had reduced the Euclidean distance in >50% of enhancing tumor voxels for 17/21 glioblastoma multiformes (62% ± 17%; P = .0041). The bidirectional model and dynamic contrast-enhanced-derived kep demonstrated a strong correlation (r = 0.74 ± 0.13). On average, enhancing tumor relative CBV for the Boxerman-Weisskoff model exceeded that for the bidirectional model by 16.6% ± 14.0%. CONCLUSIONS: Inclusion of the bidirectional exchange in leakage-correction models for single-echo DSC MR imaging improves the model fit to leakage-contaminated DSC MR imaging data and significantly improves the estimation of relative CBV in high-grade gliomas.
BACKGROUND AND PURPOSE: Contrast agent extravasation through a disrupted blood-brain barrier potentiates inaccurate DSC MR imaging estimation of relative CBV. We explored whether incorporation of an interstitial washout rate in a leakage-correction model for single-echo, gradient-echo DSC MR imaging improves relative CBV estimates in high-grade gliomas. MATERIALS AND METHODS: We modified the traditional model-based postprocessing leakage-correction algorithm, assuming unidirectional contrast agent extravasation (Boxerman-Weisskoff model) to account for bidirectional contrast agent exchange between intra- and extravascular spaces (bidirectional model). For both models, we compared the goodness of fit with the parent leakage-contaminated relaxation rate curves by using the Akaike Information Criterion and the difference between modeled interstitial relaxation rate curves and dynamic contrast-enhanced MR imaging by using Euclidean distance in 21 patients with glioblastoma multiforme. RESULTS: The bidirectional model had improved Akaike Information Criterion versus the bidirectional model in >50% of enhancing tumor voxels in all 21 glioblastoma multiformes (77% ± 9%; P < .0001) and had reduced the Euclidean distance in >50% of enhancing tumor voxels for 17/21 glioblastoma multiformes (62% ± 17%; P = .0041). The bidirectional model and dynamic contrast-enhanced-derived kep demonstrated a strong correlation (r = 0.74 ± 0.13). On average, enhancing tumor relative CBV for the Boxerman-Weisskoff model exceeded that for the bidirectional model by 16.6% ± 14.0%. CONCLUSIONS: Inclusion of the bidirectional exchange in leakage-correction models for single-echo DSC MR imaging improves the model fit to leakage-contaminated DSC MR imaging data and significantly improves the estimation of relative CBV in high-grade gliomas.
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