Sau May Wong1,2, Jacobus F A Jansen1,2, C Eleana Zhang2,3,4, Julie Staals3,4, Paul A M Hofman1,2, Robert J van Oostenbrugge2,3,4, Cécile R L P N Jeukens1, Walter H Backes1,2. 1. Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands. 2. School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, the Netherlands. 3. Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands. 4. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands.
Abstract
PURPOSE: Increased blood-brain barrier (BBB) permeability has been shown to play a significant role in the pathophysiology of cerebrovascular disease and it may provide an early functional marker of progression or treatment effects. The aim of the study was to investigate the test-retest reproducibility and influencing factors of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in measuring subtle leakage in patients with cerebrovascular disease. MATERIAL AND METHODS: DCE-MRI (3T) was performed on two separate days in 16 patients (age 66 ± 9 years) with cerebrovascular disease, prospectively. The leakage rate was quantified for white matter (WM) and gray matter (GM) using the Patlak graphical approach with individual vascular input functions (VIFs). Furthermore, the influence of session-averaged VIFs, the average of the VIFs obtained on two days, and shorter scan times (range 5-25 minutes) on the reproducibility were evaluated in WM and GM. RESULTS: Coefficients of variation (CV) ≤14.4% (WM and GM), intraclass correlation coefficients (ICCs) of 0.77 (WM) and 0.49 (GM), were observed for the leakage rate. Session-averaged VIFs hardly affected these results (CV ≤13.4%). The repeatability coefficients (RCs) of the leakage rate decreased from 2.7·10-3 to 0.4·10-3 min-1 in WM (P < 0.01) and 4.4·10-3 to 0.9·10-3 min-1 in GM (P < 0.01) with increasing scan time (range 5-25 minutes). CONCLUSION: Based on the moderate CVs and moderate-to-excellent ICCs, we demonstrate that measuring subtle BBB leakage using DCE-MRI is moderate-to-excellent reproducible. Longer scan times improve the reproducibility. The provided RCs at various scan times may assist future clinical studies investigating BBB leakage using DCE-MRI. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:159-166.
PURPOSE: Increased blood-brain barrier (BBB) permeability has been shown to play a significant role in the pathophysiology of cerebrovascular disease and it may provide an early functional marker of progression or treatment effects. The aim of the study was to investigate the test-retest reproducibility and influencing factors of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in measuring subtle leakage in patients with cerebrovascular disease. MATERIAL AND METHODS:DCE-MRI (3T) was performed on two separate days in 16 patients (age 66 ± 9 years) with cerebrovascular disease, prospectively. The leakage rate was quantified for white matter (WM) and gray matter (GM) using the Patlak graphical approach with individual vascular input functions (VIFs). Furthermore, the influence of session-averaged VIFs, the average of the VIFs obtained on two days, and shorter scan times (range 5-25 minutes) on the reproducibility were evaluated in WM and GM. RESULTS: Coefficients of variation (CV) ≤14.4% (WM and GM), intraclass correlation coefficients (ICCs) of 0.77 (WM) and 0.49 (GM), were observed for the leakage rate. Session-averaged VIFs hardly affected these results (CV ≤13.4%). The repeatability coefficients (RCs) of the leakage rate decreased from 2.7·10-3 to 0.4·10-3 min-1 in WM (P < 0.01) and 4.4·10-3 to 0.9·10-3 min-1 in GM (P < 0.01) with increasing scan time (range 5-25 minutes). CONCLUSION: Based on the moderate CVs and moderate-to-excellent ICCs, we demonstrate that measuring subtle BBB leakage using DCE-MRI is moderate-to-excellent reproducible. Longer scan times improve the reproducibility. The provided RCs at various scan times may assist future clinical studies investigating BBB leakage using DCE-MRI. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:159-166.
Authors: S M Wong; W H Backes; C E Zhang; J Staals; R J van Oostenbrugge; C R L P N Jeukens; J F A Jansen Journal: AJNR Am J Neuroradiol Date: 2017-12-07 Impact factor: 3.825
Authors: Michael J Thrippleton; Walter H Backes; Steven Sourbron; Michael Ingrisch; Matthias J P van Osch; Martin Dichgans; Franz Fazekas; Stefan Ropele; Richard Frayne; Robert J van Oostenbrugge; Eric E Smith; Joanna M Wardlaw Journal: Alzheimers Dement Date: 2019-04-25 Impact factor: 21.566
Authors: N Andres Parra; Hong Lu; Qian Li; Radka Stoyanova; Alan Pollack; Sanoj Punnen; Jung Choi; Mahmoud Abdalah; Christopher Lopez; Kenneth Gage; Jong Y Park; Yamoah Kosj; Julio M Pow-Sang; Robert J Gillies; Yoganand Balagurunathan Journal: Oncotarget Date: 2018-12-14