N B Semmineh1, L C Bell1, A M Stokes1, L S Hu2, J L Boxerman3, C C Quarles4. 1. From the Department of Imaging Research (N.B.S., L.C.B., A.M.S., C.C.Q.), Barrow Neurological Institute, Phoenix, Arizona. 2. Department of Radiology (L.S.H.), Mayo Clinic Arizona, Phoenix, Arizona. 3. Department of Diagnostic Imaging (J.L.B.), Rhode Island Hospital, Providence, Rhode Island. 4. From the Department of Imaging Research (N.B.S., L.C.B., A.M.S., C.C.Q.), Barrow Neurological Institute, Phoenix, Arizona Chad.Quarles@BarrowNeuro.org.
Abstract
BACKGROUND AND PURPOSE: The accuracy of DSC-MR imaging CBV maps in glioblastoma depends on acquisition and analysis protocols. Multisite protocol heterogeneity has challenged standardization initiatives due to the difficulties of in vivo validation. This study sought to compare the accuracy of routinely used protocols using a digital reference object. MATERIALS AND METHODS: The digital reference object consisted of approximately 10,000 simulated voxels recapitulating typical signal heterogeneity encountered in vivo. The influence of acquisition and postprocessing methods on CBV reliability was evaluated across 6912 parameter combinations, including contrast agent dosing schemes, pulse sequence parameters, field strengths, and postprocessing methods. Accuracy and precision were assessed using the concordance correlation coefficient and coefficient of variation. RESULTS: Across all parameter space, the optimal protocol included full-dose contrast agent preload and bolus, intermediate (60°) flip angle, 30-ms TE, and postprocessing with a leakage-correction algorithm (concordance correlation coefficient = 0.97, coefficient of variation = 6.6%). Protocols with no preload or fractional dose preload and bolus using these acquisition parameters were generally less robust. However, a protocol with no preload, full-dose bolus, and low (30°) flip angle performed very well (concordance correlation coefficient = 0.93, coefficient of variation = 8.7% at 1.5T and concordance correlation coefficient = 0.92, coefficient of variation = 8.2% at 3T). CONCLUSIONS: Schemes with full-dose preload and bolus maximize CBV accuracy and reduce variability, which could enable smaller sample sizes and more reliable detection of CBV changes in clinical trials. When a lower total contrast agent dose is desired, use of a low flip angle, no preload, and full-dose bolus protocol may provide an attractive alternative.
BACKGROUND AND PURPOSE: The accuracy of DSC-MR imaging CBV maps in glioblastoma depends on acquisition and analysis protocols. Multisite protocol heterogeneity has challenged standardization initiatives due to the difficulties of in vivo validation. This study sought to compare the accuracy of routinely used protocols using a digital reference object. MATERIALS AND METHODS: The digital reference object consisted of approximately 10,000 simulated voxels recapitulating typical signal heterogeneity encountered in vivo. The influence of acquisition and postprocessing methods on CBV reliability was evaluated across 6912 parameter combinations, including contrast agent dosing schemes, pulse sequence parameters, field strengths, and postprocessing methods. Accuracy and precision were assessed using the concordance correlation coefficient and coefficient of variation. RESULTS: Across all parameter space, the optimal protocol included full-dose contrast agent preload and bolus, intermediate (60°) flip angle, 30-ms TE, and postprocessing with a leakage-correction algorithm (concordance correlation coefficient = 0.97, coefficient of variation = 6.6%). Protocols with no preload or fractional dose preload and bolus using these acquisition parameters were generally less robust. However, a protocol with no preload, full-dose bolus, and low (30°) flip angle performed very well (concordance correlation coefficient = 0.93, coefficient of variation = 8.7% at 1.5T and concordance correlation coefficient = 0.92, coefficient of variation = 8.2% at 3T). CONCLUSIONS: Schemes with full-dose preload and bolus maximize CBV accuracy and reduce variability, which could enable smaller sample sizes and more reliable detection of CBV changes in clinical trials. When a lower total contrast agent dose is desired, use of a low flip angle, no preload, and full-dose bolus protocol may provide an attractive alternative.
Authors: Melissa A Prah; Mona M Al-Gizawiy; Wade M Mueller; Elizabeth J Cochran; Raymond G Hoffmann; Jennifer M Connelly; Kathleen M Schmainda Journal: J Neurooncol Date: 2017-09-12 Impact factor: 4.130
Authors: L S Hu; L C Baxter; D S Pinnaduwage; T L Paine; J P Karis; B G Feuerstein; K M Schmainda; A C Dueck; J Debbins; K A Smith; P Nakaji; J M Eschbacher; S W Coons; J E Heiserman Journal: AJNR Am J Neuroradiol Date: 2009-09-12 Impact factor: 3.825
Authors: K Leu; J L Boxerman; T F Cloughesy; A Lai; P L Nghiemphu; L M Liau; W B Pope; B M Ellingson Journal: AJNR Am J Neuroradiol Date: 2016-04-14 Impact factor: 3.825
Authors: Tiffany T Liu; Achal S Achrol; Lex A Mitchell; Scott A Rodriguez; Abdullah Feroze; Michael Iv; Christine Kim; Navjot Chaudhary; Olivier Gevaert; Josh M Stuart; Griffith R Harsh; Steven D Chang; Daniel L Rubin Journal: Neuro Oncol Date: 2017-07-01 Impact factor: 12.300
Authors: J M Hoxworth; J M Eschbacher; A C Gonzales; K W Singleton; G D Leon; K A Smith; A M Stokes; Y Zhou; G L Mazza; A B Porter; M M Mrugala; R S Zimmerman; B R Bendok; D P Patra; C Krishna; J L Boxerman; L C Baxter; K R Swanson; C C Quarles; K M Schmainda; L S Hu Journal: AJNR Am J Neuroradiol Date: 2020-03-12 Impact factor: 3.825
Authors: K M Schmainda; M A Prah; L S Hu; C C Quarles; N Semmineh; S D Rand; J M Connelly; B Anderies; Y Zhou; Y Liu; B Logan; A Stokes; G Baird; J L Boxerman Journal: AJNR Am J Neuroradiol Date: 2019-03-28 Impact factor: 3.825
Authors: Timothy J Kaufmann; Marion Smits; Jerrold Boxerman; Raymond Huang; Daniel P Barboriak; Michael Weller; Caroline Chung; Christina Tsien; Paul D Brown; Lalitha Shankar; Evanthia Galanis; Elizabeth Gerstner; Martin J van den Bent; Terry C Burns; Ian F Parney; Gavin Dunn; Priscilla K Brastianos; Nancy U Lin; Patrick Y Wen; Benjamin M Ellingson Journal: Neuro Oncol Date: 2020-06-09 Impact factor: 12.300
Authors: Ashley M Stokes; Natenael B Semmineh; Ashley Nespodzany; Laura C Bell; C Chad Quarles Journal: Magn Reson Med Date: 2019-08-09 Impact factor: 4.668
Authors: Ashley M Stokes; Maurizio Bergamino; Lea Alhilali; Leland S Hu; John P Karis; Leslie C Baxter; Laura C Bell; C Chad Quarles Journal: J Cereb Blood Flow Metab Date: 2021-08-20 Impact factor: 6.960
Authors: Joshua D Bernstock; Sam E Gary; Neil Klinger; Pablo A Valdes; Walid Ibn Essayed; Hannah E Olsen; Gustavo Chagoya; Galal Elsayed; Daisuke Yamashita; Patrick Schuss; Florian A Gessler; Pier Paolo Peruzzi; Asim K Bag; Gregory K Friedman Journal: Neurooncol Adv Date: 2022-05-26
Authors: Jerrold L Boxerman; Chad C Quarles; Leland S Hu; Bradley J Erickson; Elizabeth R Gerstner; Marion Smits; Timothy J Kaufmann; Daniel P Barboriak; Raymond H Huang; Wolfgang Wick; Michael Weller; Evanthia Galanis; Jayashree Kalpathy-Cramer; Lalitha Shankar; Paula Jacobs; Caroline Chung; Martin J van den Bent; Susan Chang; W K Al Yung; Timothy F Cloughesy; Patrick Y Wen; Mark R Gilbert; Bruce R Rosen; Benjamin M Ellingson; Kathleen M Schmainda Journal: Neuro Oncol Date: 2020-09-29 Impact factor: 12.300
Authors: Kathleen M Schmainda; Melissa A Prah; Helga Marques; Eunhee Kim; Daniel P Barboriak; Jerrold L Boxerman Journal: Neuro Oncol Date: 2021-02-25 Impact factor: 13.029
Authors: Laura C Bell; Natenael Semmineh; Hongyu An; Cihat Eldeniz; Richard Wahl; Kathleen M Schmainda; Melissa A Prah; Bradley J Erickson; Panagiotis Korfiatis; Chengyue Wu; Anna G Sorace; Thomas E Yankeelov; Neal Rutledge; Thomas L Chenevert; Dariya Malyarenko; Yichu Liu; Andrew Brenner; Leland S Hu; Yuxiang Zhou; Jerrold L Boxerman; Yi-Fen Yen; Jayashree Kalpathy-Cramer; Andrew L Beers; Mark Muzi; Ananth J Madhuranthakam; Marco Pinho; Brian Johnson; C Chad Quarles Journal: Tomography Date: 2020-06